Guide
Knee replacement on the NHS: criteria, waiting and alternatives
Updated
Before any private figure is worth weighing, it helps to know what the NHS actually offers, what it tries first, and how long the queue at your own hospital is.
When the NHS says a replacement is considered
The NHS says a knee replacement may be recommended if knee pain is having a big effect on your life and alternatives to a knee replacement have not worked, and that most people having one have pain and movement problems caused by osteoarthritis. It describes the operation as replacing damaged parts of the joint with metal or plastic parts, and notes that knee replacements can last 20 years or more (nhs.uk).
What is normally tried first
- Weight loss to reduce the strain on the knee where a person is overweight
- Low-impact exercise such as swimming, walking or cycling, and muscle strengthening, with physiotherapy support
- Walking aids, and special footwear or insoles
- Pain relief medicines, gels or creams
- Hydrocortisone (steroid) injections into the knee joint to help with pain and swelling
The NHS also lists other operations that may be options instead of a replacement for some people, including arthroscopy, osteotomy, microfracture and scaffold insertion, and says these are not suitable for everyone. All of that is on the NHS page about alternatives to a knee replacement.
How long the NHS wait is
Orthopaedic waits differ widely between hospitals, so a single national average would be the least useful figure we could publish. Two things are precise. In England the NHS states a maximum 18-week wait for non-urgent consultant-led treatment from referral, along with the right to ask to be seen or treated by a different provider if you are likely to wait longer, and a right to another binding date within 28 days if an operation is cancelled at the last minute for non-clinical reasons (nhs.uk). And your own hospital's waiting information is published weekly on My Planned Care, which also lets you compare local hospitals by postcode.
What recovery looks like either way
- In hospital
- The NHS says the operation usually takes about 1 to 2 hours, that you will be helped to start walking soon afterwards with crutches or a frame, and that most people can leave hospital 1 to 3 days after the operation.
- The first weeks
- The NHS says a nurse takes out stitches or clips after about 10 days, with a follow-up appointment about 6 weeks after the operation.
- Driving
- The NHS advises waiting at least 6 weeks to drive again after a total knee replacement, or 3 weeks after a partial, and checking with your doctor that you are fit to drive.
- Work
- The NHS says people return to work when they feel ready, usually after about 6 to 12 weeks, depending on the type of work.
- Full recovery
- The NHS says it may take several months or longer to fully recover, and advises against household tasks involving lifting or moving anything heavy for the first 3 months.
If you have been told you do not currently meet local criteria, ask which criteria were applied and what would change the position. That is a conversation with your GP or the referring service, and it is worth having before you commit several thousand pounds.