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TOTAL KNEE REPLACEMENT SPECIALIST

Total Knee Replacement Surgery in Nottingham & Derby

Total knee replacement can help relieve pain and restore function when arthritis affects several areas of the knee. Mr Navjot Bhangoo provides individually planned total knee replacement surgery, including robotic-assisted surgery where appropriate.

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When might a total knee replacement be needed?

Total knee replacement may be considered when arthritis affects several areas of the knee and pain, stiffness or loss of movement is having a significant impact on everyday life. This differs from arthritis confined to a single compartment, which may be suitable for partial knee replacement.

The decision is not based on an X-ray alone. Symptoms, examination findings, imaging and the response to appropriate non-surgical treatment are considered together.

  • Widespread arthritisDamage affecting more than one area of the knee joint.
  • Persistent pain and stiffnessSymptoms that significantly affect walking, everyday activities or quality of life.
  • Non-surgical treatment is no longer providing sufficient reliefAppropriate treatments such as physiotherapy, activity modification, medication or injections may have already been explored.

Not everyone with knee arthritis needs a total knee replacement. Mr Bhangoo will assess the pattern and extent of arthritis alongside your symptoms and individual circumstances to determine the most appropriate treatment approach.

Knee X-rays showing osteoarthritis reviewed during assessment for total knee replacement

What is actually replaced during a total knee replacement?

Arthritic knee compared with a knee after total knee replacement

Despite its name, a total knee replacement does not mean removing the entire knee. Instead, the damaged joint surfaces at the ends of the thigh bone and shin bone are carefully prepared and resurfaced with precisely positioned implant components. The surrounding bone and soft tissues are preserved where appropriate.

A smooth polyethylene insert sits between the metal components, creating a new bearing surface that allows the knee to move.

  • Femoral componentA metal component resurfaces the damaged end of the thigh bone (femur).
  • Tibial componentA metal baseplate is positioned on the prepared upper surface of the shin bone (tibia).
  • Polyethylene insertA smooth, durable plastic insert sits between the metal components and forms the new bearing surface of the joint.

The kneecap is assessed during surgery and managed according to the needs of the individual knee.

Planning your knee replacement

Every knee is different. Careful planning before total knee replacement helps determine the appropriate implant size, position and alignment for the individual patient.

Mr Bhangoo reviews your symptoms, examination findings and imaging to understand both the extent of arthritis and the anatomy of your knee.

Digital planning of implant position and alignment for total knee replacement surgery

Planning considers factors including:

  • Knee anatomyThe shape and dimensions of the individual knee.
  • Implant positionPlanning the size and position of the replacement components.
  • AlignmentConsidering how the knee and leg are aligned as part of the overall surgical plan.
  • Soft-tissue balanceAssessing the ligaments and surrounding soft tissues to help achieve a stable, balanced knee.

The aim is to create a carefully planned knee replacement tailored to the individual rather than applying exactly the same approach to every patient.

What happens during total knee replacement surgery?

During total knee replacement surgery, the damaged surfaces of the knee are carefully prepared and resurfaced with implant components selected and positioned according to the surgical plan.

Total knee replacement surgery being performed in a modern operating theatre
  1. Preparing the joint

    The damaged surfaces at the ends of the femur and tibia are carefully prepared to receive the replacement components.

  2. Positioning the implants

    The femoral and tibial components are positioned, with a polyethylene insert placed between them to create the new bearing surface.

  3. Checking alignment and balance

    The knee is assessed through its range of movement, with alignment, stability and soft-tissue balance checked before the final components are secured.

  4. Completing the procedure

    Once the knee is stable and moving appropriately, the surgical site is closed and the patient begins the early stages of recovery and rehabilitation.

The Triathlon total knee replacement system

Total knee replacement showing knee implant components and arthritic knee

Mr Bhangoo uses the Triathlon Total Knee System for total knee replacement surgery. It is a well-established knee replacement system with a long clinical history and is used internationally.

The system includes components that resurface the ends of the thigh bone (femur) and shin bone (tibia), with a smooth polyethylene bearing between them.

Choosing and positioning the implant

The implant is only one part of a successful knee replacement. The appropriate component size and position are planned for the individual knee, taking into account anatomy, alignment, stability and soft-tissue balance.

Where appropriate, the Triathlon system can also be used with Mako robotic-assisted surgery.

Mako robotic-assisted total knee replacement

Mako is a robotic-assisted surgical system that can be used by Mr Bhangoo when performing total knee replacement with the Triathlon knee system.

The technology provides detailed information about the patient’s knee and allows the planned implant position to be assessed and refined during surgery.

Mako robotic-assisted total knee replacement surgery in a modern operating theatre

  1. Plan

    Information about the individual knee is used to create a personalised surgical plan, including the intended position and alignment of the implant components.

  2. Assess

    During surgery, Mr Bhangoo can assess the knee’s anatomy, alignment and soft-tissue balance and make appropriate adjustments to the plan.

  3. Assist

    The robotic arm assists Mr Bhangoo in carrying out the planned bone preparation within defined boundaries before the replacement components are positioned.

Mr Bhangoo remains in control

Mako does not independently perform the knee replacement. The technology provides information and surgical assistance, while Mr Bhangoo makes the clinical decisions and performs the operation.

What are the aims of total knee replacement?

The main aim of total knee replacement is to reduce pain from an arthritic knee and improve function when symptoms are significantly affecting everyday life.

Reduce arthritis pain

Replacing the damaged joint surfaces aims to reduce the pain associated with advanced knee arthritis.

Improve movement and function

For many patients, improving knee function can make everyday activities such as walking, using stairs and getting out and about more manageable.

Support a more active everyday life

The aim is to help patients return to the activities that matter to them, while recognising that recovery and the level of activity achieved vary between individuals.

Every patient’s starting point and recovery are different. Mr Bhangoo will discuss what you can realistically expect from surgery based on your knee, general health and individual goals.

Recovery and rehabilitation after total knee replacement

Patient completing physiotherapy rehabilitation after total knee replacement surgery

Recovery after total knee replacement is a gradual process. Early movement and physiotherapy are important parts of rehabilitation, with activity building progressively as strength, movement and confidence improve.

  1. Early mobilisation

    Patients are usually encouraged to begin moving soon after surgery with appropriate support from the clinical and physiotherapy team.

  2. The first few weeks

    The initial focus is on walking safely, managing swelling, restoring knee movement and gradually becoming more independent with everyday activities.

  3. Building strength and function

    Physiotherapy progresses as recovery allows, with exercises aimed at improving strength, movement, balance and functional ability.

  4. Longer-term recovery

    Improvement continues over time. The pace of recovery and return to activities varies according to the individual, their starting point and their progress following surgery.

Knee Replacement Recovery Timeline: What to Expect Week by Week

Specialist expertise in total knee replacement

Mr Navjot Bhangoo explaining knee treatment options to a patient using an anatomical knee model

Mr Navjot Bhangoo is a Consultant Orthopaedic Knee Surgeon specialising in the assessment and surgical treatment of knee conditions, including knee replacement surgery.

His approach to total knee replacement combines careful clinical assessment with individual surgical planning, taking into account the pattern of arthritis, knee anatomy, alignment and the patient’s symptoms and goals.

He performs total knee replacement using established surgical techniques and, where appropriate, robotic-assisted technology such as Mako.

The aim is to recommend the treatment and surgical approach most appropriate for the individual patient rather than taking a one-size-fits-all approach to knee replacement.

Find out more about Mr Bhangoo

Ready to discuss your knee?

If knee arthritis is affecting your everyday life, arrange a consultation with Mr Bhangoo to discuss your symptoms, treatment options and whether knee replacement may be appropriate for you.

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Total knee replacement FAQs

  • How do I know if I need a total rather than partial knee replacement?

    The decision depends on your symptoms and the pattern and extent of arthritis within the knee. Partial knee replacement may be suitable when arthritis is confined to a particular part of the joint, whereas total knee replacement may be considered when arthritis is more widespread. Mr Bhangoo will assess your knee clinically and review your imaging before recommending the most appropriate option.

  • How long does a total knee replacement last?

    Modern knee replacements are designed for long-term use, but the lifespan of an implant varies between individuals. Factors including age, activity, implant type and individual circumstances can influence how long a knee replacement lasts. Mr Bhangoo can discuss this with you as part of your consultation.

  • What is Mako robotic-assisted knee replacement?

    Mako is a robotic-assisted surgical system that can be used to support planning and execution of total knee replacement. It provides detailed information about the individual knee and assists the surgeon during bone preparation and implant positioning. The robot does not perform the operation independently — Mr Bhangoo remains in control throughout the procedure.

  • How painful is recovery after total knee replacement?

    Pain and swelling are expected following knee replacement surgery and are managed as part of the post-operative recovery programme. Symptoms generally improve as healing progresses, although recovery varies between individuals. Movement, physiotherapy and gradually increasing activity form important parts of rehabilitation.

  • When can I drive after total knee replacement?

    The timing varies according to the individual, which knee has been operated on, recovery of strength and movement, medication use and the ability to control the vehicle safely. Mr Bhangoo and the rehabilitation team can advise when it is appropriate for you to return to driving.

  • When can I return to work and normal activities?

    This depends on your recovery and the physical demands of your work and usual activities. People with desk-based roles may return sooner than those whose work is physically demanding. Activity should be increased progressively as strength, movement and confidence improve.

    Knee Replacement Recovery Timeline: What to Expect Week by Week →

  • Can I exercise after a total knee replacement?

    Returning to exercise is usually gradual and depends on your recovery, previous activity level and individual circumstances. Lower-impact activities are commonly introduced as rehabilitation progresses. Mr Bhangoo and your physiotherapy team can advise on appropriate activities for your individual knee.

  • Can a total knee replacement be revised in the future?

    A knee replacement may occasionally require further surgery in the future if problems develop with the implant or surrounding knee. This is known as revision knee replacement. The need for revision varies between individuals and is assessed according to symptoms, examination and imaging.