What kinds of exercises are advised after knee surgery?

exercising after knee surgery in BirminghamUndergoing any type of surgery will generally require a period of rehabilitation during the days, weeks and months following the surgery.

Exercise will often be advised to strengthen the muscles around the affected area, but it is important that you only partake in exercises recommended by your surgeon, so that you do not push your body too far.

Recovering from knee surgery – what is advised?

If you’ve had knee surgery then exercise is recommended so that you can begin to build up your strength and mobility again, both of which are vital in terms of getting you off crutches and ensuring you’re back on the road to independence.

In the first days after surgery you will be able to do some exercises from a bed or chair, which will begin the healing process and start preparing your body for being mobile again. Exercises such as straightening your leg and gently raising it up and down (in short bursts, holding each raise for around 10-15 seconds) of are recommended as this helps build strength back up in your thigh muscles.

Ankle exercises are also suggested, such as pointing your toes outwards and then back again (aim to do this for a couple of minutes at a time, and then relax). This flexes your calf muscles and helps reduce any swelling caused by inactivity.

After the first few days

The first starting point will usually be gentle walking exercises. To begin with, this will probably need the support of crutches or a walking aid, and you will be encouraged to do short periods of walking (usually no more than 20 or 30 minutes at a time). This will not only begin to build up the muscles around the operation site, but will restore confidence and balance too.

The next step is often going up and down stairs, which this targets different muscles and puts pressure on different areas compared with walking on a flat surface. The process of going up and down stairs works out different muscles, so both directions are beneficial. The important thing is to ensure that you have a sturdy handrail to give you the required support.

Any pain or discomfort

If you suffer from pain or you notice swelling after undertaking any rehabilitation exercises then consult your surgeon to talk again about your exercise regime.

In the meantime, elevating the affected area and applying an ice pack (wrapped in a towel so that it does not make direct contact with the skin) should help ease any pain and will help reduce any inflammation.

Speaking to your surgeon quickly is important to ensure that any exercises that are being undertaken are not hindering your recovery.

Understanding conditions that can lead to hip replacements – acetabular fractures

Birmingham hip surgeon explains acetabular fracturesA hip replacement is the last step in a chain of treatments consultants can try if you have been suffering from any number of hip complaints. One of the more serious conditions that patients may have suffered with before being referred to a hip consultant is an acetabular fracture.

An acetabular fracture is quite a rare infliction, one which typically occurs from a serious accident such as a car accident or a fall from height. It is a fracture in the primary hip socket, known as the hip’s ball and socket joint.

The ‘ball’ element of the hip socket is the top of the thighbone, or femur. This fits into the area known as the ‘socket’, which is within the pelvis. Both the ball and the socket are bones that are covered with articular cartilage – this is a smooth, oily substance that is designed to protect the bones and to give them the opportunity to move without causing friction.

It is the same principle as oiling a joint in any piece of complex machinery – and in this case, the complex machine is the body.

An acetabular fracture can affect how comfortably the ‘ball’ element of the hip bone sits within the ‘socket’ and the result can be that abnormal pressure is exerted on areas of the joint – in particular the joint’s important cartilage.

If this is not recognised and treated early enough, this can result in longer term issues with how the joint functions, which over time can lead to the need for a hip replacement later in life.

What can I expect from an acetabular fracture?

The severity of the fracture depends on a number of different variables, such as whether it is a clean break or if there are multiple fractures (multiple fracture are more challenging to fix), how fragmented the broken pieces of bone are, and how much damage has been done to the cartilage protecting the bone.

The body’s ability to heal successfully can also be affected by how much trauma there is to the surrounding area too, such as the muscles, nerves and tendons surrounding the hip bones.

What exactly are the long term issues caused by acetabular fractures?

If left untreated, poorly treated, or in cases where it is particularly challenging to effectively treat the fracture(s), acetabular fractures can wear away the hip cartilage to such as extent they can result in arthritis. After suffering such an injury to the ball and socket joint, patients have an increased susceptibility to posttraumatic degenerative arthritis of the hip joint.

If you have been diagnosed with posttraumatic degenerative arthritis then it is important to contact a hip or joint specialist to review your options.

Consultants such as Birmingham hip surgeon Mr Manoj Sikand will be able to assess your case and evaluate your options. If a hip replacement is going to be the most appropriate course of action, you will be given the necessary support, information and guidance to understand what the next steps look like for you, and how best to proceed.

Ways to delay needing a total hip or knee replacement

Ways to delay total joint replacement surgery in BirminghamIf you suspect that you are going to need a total hip or knee replacement, then it is sensible to start researching surgical options sooner rather than later. However, while you are doing that, there are some simple steps you can take that might delay the process and buy you a little more time.

Take up a gentle exercise routine

If you are suffering from a minor to middling form of osteoarthritis, and this is what is causing your joints to seize up, then doing some gentle exercises can help. As well as making you feel healthier overall, this can really help your joints by keeping them regularly active.

Experts recommend that one hour of low impact exercise at least two times per week for around three months can have a positive effect on how your body reacts to osteoarthritis. Gentle, regular exercise can help keep the joints supple and increase blood flow.

The best time to begin a regime such as this is before you are actually showing any symptoms of osteoarthritis, however, if you are getting the early twinges of joint pain then it is never too late to start.

Watch those calories

Increasing the amount of exercise you are doing can also have the dual benefit that it can help you lose excess weight. If you are carrying more weight that you should be then this will be putting more stress on your hip and knee joints.

Watching calorie intake and increasing the amount of exercise you do is a great way to ensure that you’re not putting more pressure on your joints than you really need to.

Supplement your diet with key vitamins and minerals

There are certain vitamins and minerals that are proven to have a positive impact on joint health, so weaving these into your diet is also a sensible step to take.

A daily intake of tablets such as chondroitin or glucosamine sulphate (both of which can be bought online or in some high street pharmacies) can help alleviate joint pain and can also slow the progress of osteoarthritis.

Knee replacement surgery – reassuringly well practised

stretchingIf you require knee surgery, then it is reassuring to know that you are not alone. Many people undergo this type of operation every year in the UK, and it is one of the most long standing joint replacement treatments available.

Before knee replacement surgery was invented, the solution for people suffering debilitating knee conditions was purely to take a form of pain relief. For anyone who has experienced serious knee ailments, they will recognise that this was never going to be a permanent fix that will restore former quality of life.

Scientists endeavoured to create an artificial replacement joint, one that was able to replicate the natural movements of a non-diseased knee joint and one that was made of such materials that it was both durable and able to coexist suitably inside the body.

A short history of knee replacement

The first recorded knee replacement surgery was undertaken back in the late 1960s. This operation was a success, but since then the tools, techniques and procedures have become more refined, sophisticated and developed, meaning that knee replacement surgery has an excellent track record of effectiveness.

It is now regarded to be one of the most successful surgical procedures that patients can benefit from.

As with any operation of this nature, choosing to undergo knee replacement surgery is a big step and a major operation. If you have been suffering with knee conditions for a long time, your medical team will wish to try all other means of fixing the problem first, before resorting to surgery.

First line options

Typically you will be expected to try different types of pain relief, physiotherapy and initiatives such as steroid injections before you will be considered as a suitable contender for surgery. If these have been tried, tested and you are still experiencing significant discomfort and mobility issues, then surgery will be discussed.

Nowadays, this type of operation is commonplace. According to NHS statistics, over 70,000 knee replacements are carried out every year in England and Wales, and this number continues to rise each year.

The good news is that the life expectancy of the new joint is extensive too – 20 years is the expected life of a replacement joint, so it should last you well.

What causes patients to require knee replacements?

knee injectionThere are many reasons they patients are recommended knee replacements, but the most common are arthritis or knee deformities.


There are three main culprits when it comes to arthritis and knee problems, these are post-traumatic arthritis, osteoarthritis and rheumatoid arthritis.

Post-traumatic arthritis occurs when the knee has been subjected to external trauma, such as a break or fracture to the bone, or perhaps ligament tearing. Following the trauma the knee often becomes inflamed and this can have a negative impact on the alignment of the different components inside the knee. Over time, this can result in damage to the cartilage.

Osteoarthritis is the most common cause of joint disease, and results from the cartilage rubbing together unnaturally, causing friction around the joint. This is painful and can restrict movement, and will usually need medical intervention to reify the problem in the longer term.

Finally, rheumatoid arthritis is an autoimmune condition, which means the body’s immune system mistakenly identifies some of its own mechanisms for enemy cells, and attacks them. In this case, the immune system targets the membranes that line the knee joints, resulting in inflammation, pain and restricted mobility. Eventually this will destroy the joint.

Knee deformities

The other common reason that knee replacements are required is when the knee (or sometimes both knees) are subject to deformities such as bowed legs (whereby the legs bend out unnaturally) or knock-knees (where they bend inwards and rub together).

Over time, the unnatural angle of conditions such as these causes stress on the joints and results in excess wear and tear of the cartilage. This can be painful and exacerbate the mobility restrictions. Knee surgery can offer a solution to target the source of the problem and the resulting pain.

Next steps

If you have been advised that a complete knee replacement is the best route to go down, then be reassured to know that it is one of the most common types of joint replacement surgery, and one that surgeons have been practicing for decades.

The operation itself involves removing the original joint (or parts of it) and replacing the components that have been worn out with replacement parts that are artificially created.

To find out more, contact Birmingham knee surgeon Mr Manoij Sikand who will talk you through all the different options available and help you make the most informed decision about the next steps to take.

More people are opting for hip replacements to improve their quality of life

running-1275803_960_720It is well documented that Britain now has an increasing ageing population, thanks to the baby boomer generation starting to reach their retirement years.

With increased age naturally comes increased wear and tear on joints, bones, muscles and ligaments. Some people will choose to ‘keep calm and carry on’ ignoring the discomfort and putting on a brave face. They may justify this as just one of the things you have to put up with as you get older.

Encouragingly though, this is not the case for everyone. There is an increasing trend that as people are getting closer to retirement, instead of putting up with discomforts, people are being more proactive about getting them fixed.

Prepared to take action

According to a recent report published by NHSE (NHS England), the number of hip replacement operations on people aged under 60 has risen 76% in the last decade. Such a significant increase suggests that there is a shift in mentality – fewer people are prepared to just accept their aging joints, but rather are prepared to do something about it.

This is a heartening trend, and one that shows that as people’s understanding grows of what medical treatment is available to them and the benefits that medical intervention can bring, they are opting for treatments that can help significantly improve their quality of life.

The Royal College of Surgeons, the professional body that represents surgeons in the UK and around the world, suggests that one of the reasons that confidence in operations such as hip replacements is growing is that doctors can now reassure patients that the replacement joints are much more durable than they were in the past.

More proactive mindset

There is also an attitudinal shift, which suggests that patients are no longer prepared to suffer in silence and wait until the problem gets too severe. Instead, they are opting to try and nip the problem in the bud, and explore their options earlier.

If this sounds familiar and you are concerned about your hip or knee joints and/or ligaments, book an appointment to explore your options with Mr Manoij Sikand, who will be able to assess your case and talk you through all options available.

Understanding the options: Different types of hip replacements

Hip_prosthesisIf you are considering a hip replacement, the first starting point is to understand what your options are. Consultants like Mr Manoij Sikand offer three types of hip replacements, each of which is a slightly different approach, and the recommendation is dependent on your personal circumstances.

Total hip replacement

This is a surgical operation, whereby your surgeon has assessed that the extent of decay or disease in your natural hip joint is so severe, the whole of the bone and cartilage are replaced with a man-made alternative. This operation includes the replacement of the whole of the ball and socket joint that makes up your hip.

This type of operation has been performed by surgeons for decades; it was first undertaken in 1960. Since the early operations over half a century ago, techniques and rates of success have continued to climb, and this type of operation is considered to be greatly effective.

Nevertheless, in very active (often younger) individuals, even the most effective total hip replacements may wear out over time, if put under continued stress once the healing process is complete.

Hemi replacement

If your case is less severe, you might be recommended for a hemi replacement, in which the ball of the femur is replaced by a prosthetic alternative. This is also commonly referred to as a hemiarthroplasty.

Unlike the extensiveness of the total hip replacement, during a hemi replacement surgeons will remove just the head of the femur bone and replace it with a new ‘ball’. This type of operation if often more suitable for older patients who are likely to have a lower level of activity, thereby will put less strain on the new joint.

Surface replacement

Finally, you might be considered for a surface replacement, which means the outer layer of both the ‘ball’ and ‘socket’ in your hip joint are removed and the surface is replaced with a metal lining. This procedure is designed to protect the bone and to prevent against the risk of more serious implications further down the line.

Unlike the total hip replacement and the hemi replacement techniques, this operation retains the majority of the femur bone, so is often referred to as a ‘bone conserving’ operation.

The benefit of the surface replacement is the dexterity that patients are left with post operatively. As the new prosthetic surfaces of both the ball and socket are moulded around the original bone anatomy, there is low risk of dislocation and the range of movement patients are left with is typically very broad.

How to choose your hip or knee surgeon

doctorsFor many people, making the decision to undergo any type of surgery can be a daunting experience. The internet offers access to hundreds of consultants and surgeons, but if you are considering hip or knee surgery, how do you know that you are getting the best treatment from the most trustworthy source?


The first thing to do is to have a look at their website and read some of the testimonials. This is a great way to hear firsthand how others have found the experience with the surgeon you are considering. If possible, ask if it is possible to contact a few of these people directly if you wish to speak to them more thoroughly about their overall experience and whether or not they would recommend it to others.


The next important thing is to look at the surgeon’s professional qualifications and membership of professional bodies. Surgeons like Mr Manoj Sikand are members of specialist, reputable membership organisation, such as the Royal College of Physicians and Surgeons of Glasgow.

Mr Sikand’s college is the only multidisciplinary Royal College in the UK, which has been offering support and representation for its members for over 400 years by setting the highest possible standards of health care. With regulation and standards stipulated by colleges such as this, you can be reassured that the calibre of work by surgeons who are members of such institutions is reflective of the standards expected by the College.

If this information is not readily available, have a look at the post nominals (letters after their name) listed by the surgeon you have in mind. For UK-based practitioners, the acronym ‘MRCS’ or ‘FRCS’ means that the surgeon is a member (through successfully completing the intercollegiate exams) or a fellow (a further enhanced grade of membership, usually achieved by demonstrating experience within the industry) of the Royal College of Surgeons.


To further put your mind at rest, book a consultation with the surgeon and come prepared with any questions you might have. Consider asking questions about the operation you are considering, such as how many times they have performed the operation? Will the surgeon you are talking with now be the one who undertakes the operation? What kind of aftercare is available after the operation?

Don’t be afraid to ask lots of questions, making this decision is very important and should not be made in haste.

Can joint replacements become infected?

sore kneeOnce you have undergone any kind of joint replacement, it is critical that you take good care of the joint in the weeks and months after the operation.

Getting an infection in the joint site is rare (usually seen in less than 1% of cases in the first three months after surgery) but it not unheard of, so ensure that you are keeping a close eye on your joint through the healing process, and know what to look out for if you suspect that you may have picked up an infection.

Before the operation

Before agreeing to perform the operation, your surgeon will talk to you in detail about any existing skin complaints prior to recommending a joint replacement. This is because unlike normal tissue in the body, a prosthetic joint replacement is unable to defend against infection, therefore is more susceptible to picking up infections, compared with the original joint.

The reason for this increased susceptibility is because the new joint will not have its own blood supply, which is what helps the body fight against infections.

Generally speaking, your surgeon will need to be reassured that any existing skin complaints are under control, or not particularly serious, if they are to undertake joint replacement surgery. This is because they wish to minimise the risk of an infection being passed to the new joint site.

After your operation

In the weeks and months after your operation, it is very important to ensure that you keep the wound site clean and sterile, so that it heals quickly and effectively. If you are concerned that the wound does not appear to be healing, it is red, or warm to the touch, seek medical attention quickly, as you may need a course of antibiotics to treat an infection.

An infection at the surface can be unpleasant, although it is not always serious, whereas if it spreads to the joint site it can be trickier to treat and potentially more serious. The same principle applies to if you pick up an injury or wound to a different area of the body and believe that it has become infected.

The new joint site will be more prone to picking up an infection if germs enter the body, so seek medical attention quickly if you suspect infection, to ensure that anything that could cause you, or your new joint, harm are treated quickly.

What causes infectious arthritis, and is it curable?

hip-778099_960_720Most people have heard of arthritis, although unless they have suffered from it, or know someone who has suffered or is suffering with it, the chances are they have assumed that all arthritis is the same.

This is not the case – there are in excess of 150 types of rheumatic disease that could be described as arthritis, and one of the lesser known types of arthritis is that which is borne through infections.

About infectious arthritis

Infectious arthritis is known by a variety of names, including ‘bacterial arthritis’ or ‘septic arthritis’, and it is caused when staphylococcal or streptococcal bacteria enter the body. There are two ways that a person can contract infectious arthritis, and that’s by the infection entering their bloodstream through an infected wound, or sometimes even directly, when particular joints are directly exposed to trauma – for example a bad break or fracture.

This type of arthritis can target any number of joints in the body, although most commonly it is found to affect either the knees or hips.

How do I know if I have got infectious arthritis?

This condition causes a lot of pain around the joint area; it will also look swollen, redder than the skin around it and feel warm to the touch. Those who are suffering from this type of infection will also usually be running a fever. In addition, it is likely that you will be suffering from reduced mobility in the affected joint(s).

If you suspect that you may be suffering from this type of arthritis, arrange to see a doctor quickly. This will probably involve a blood test, and also extraction of some of the fluid that exists within the affected joint – this is to help doctors identify the type of bacteria that is causing the problem.

Unlike many forms of arthritis, this can be treated with relative ease, and the sooner you are correctly diagnosed, the sooner you will be prescribed medicine that will work to combat the infection. Antibiotics will be used to target the infection, although you should expect a short stay in hospital so that these can be administered intravenously and that your progress can be monitored closely throughout treatment.