Patient Education Resource
Everything you need to know about hip and knee replacement — written for patients and their families by a consultant orthopaedic surgeon.
Choose Your Pathway
1
Understanding Your Condition
What OA is, how it progresses, and what it means for your joints
5 articles
Article 01
What is Osteoarthritis?
The biology of cartilage loss, bone-on-bone contact, and why OA develops.
Article 02
Hip Osteoarthritis — Symptoms, Examination and X-rays
Symptoms, patterns, clinical examination, and X-ray findings specific to hip OA.
Article 03
Knee Osteoarthritis — Symptoms, Examination and X-rays
Symptoms, compartment patterns, clinical examination, and X-ray findings specific to knee OA.
Article 04
How OA Progresses — and Why Timing Matters
The spectrum from mild to bone-on-bone, and how delay can affect surgical outcomes.
Article 05
When It Is Not OA — Other Causes of Hip and Knee Pain
Inflammatory arthritis, AVN, post-traumatic arthritis — and why the diagnosis changes management.
2
Considering Surgery
Non-surgical options, decision-making, and preparing your body
6 articles
Article 06
Non-Surgical Options — What Actually Works
Physiotherapy, weight loss, walking aids, bracing — with honest evidence for each.
Article 07
Injections Explained — Cortisone, Hyaluronic Acid and PRP
What the evidence says — and the honest limits of injection therapy.
Article 08
The Decision to Have Surgery
Shared decision-making, patient-reported outcomes, and what “ready for surgery” looks like.
Article 09
Your Role, Your Family’s Role, Your Team’s Role
Surgical decision-making as a shared process across patient, family, and the MDT.
Article 10
Am I Fit for Surgery? Pre-operative Optimisation
Weight, HbA1c, smoking, dental health — how to maximise your surgical safety.
Article 11
Pre-habilitation — Getting Stronger Before Surgery
Why the fitter you go in, the better you come out.
3
Understanding the Risks
Honest, structured information about what can go wrong — and how teams mitigate it
7 articles
Article 12
General Surgical Risks — What They Really Mean
Bleeding, clots, infection, anaesthetic complications — in plain English.
Article 13
Anaesthetic Risks — GA, Spinal and Nerve Blocks
The difference between general and spinal anaesthesia, nerve blocks, and sedation.
Article 14
Specific Risks of Total Hip Replacement
Dislocation, leg length discrepancy, nerve injury — THR-specific risks explained.
Article 15
Specific Risks of Total Knee Replacement
Stiffness, patellar complications, persistent pain — TKR-specific risks explained.
Article 16
Comorbidity-Related Risks
Immunosuppression, diabetes, obesity, cardiac disease — how your health affects surgical risk.
Article 17
How Your Surgical Team Mitigates Risk
WHO checklists, VTE prophylaxis, ERAS protocols and the MDT approach to safety.
Article 18
Risks of Revision Surgery — Why It Is a Bigger Operation
What revision means, why outcomes are generally less predictable, and how to delay or avoid it.
4
The Operation
Implants, approaches, bearings, and what actually happens in theatre
9 articles
Article 19
History of Hip Replacement — The Operation of the Century
From Charnley’s garage to modern robotics — the most successful operation in surgical history.
Article 20
Surgical Approaches in THR — Posterior, Anterior, Lateral, SPAIRE
The evidence, trade-offs, and NJR data behind each approach.
Article 21
Cemented, Uncemented and Hybrid Fixation in THR
What GIRFT, the NJR, and the evidence base say about how your implant should be fixed.
Article 22
Bearing Surfaces in THR — Metal, Ceramic, Polyethylene
What sits inside your new hip — and why the choice matters for longevity.
Article 23
Surgical Approaches in TKR
Medial parapatellar, subvastus, midvastus — how the knee is opened and why it matters.
Article 24
Implant Constructs in TKR — CR, PS, Kinematic Alignment
Cruciate-retaining vs posterior-stabilised, and the alignment philosophy debate.
Article 25
Patellar Resurfacing — To Do or Not to Do?
One of the most debated decisions in knee surgery — what does the evidence say?
Article 26
Robotic and Computer-Assisted Surgery
Mako, Navio, and image-guided systems — separating the marketing from the evidence.
Article 27
What Happens on the Day — An Hour-by-Hour Guide
From admission to recovery ward — what to expect and who you will meet.
5
Recovery and Rehabilitation
The patient-driven process that determines your outcome
8 articles
Article 28
The First 24 Hours After Surgery
Pain, mobility, catheters, and why you will be stood up the same day.
Article 29
Enhanced Recovery After Surgery (ERAS)
Why modern joint replacement means earlier mobilisation and better outcomes.
Article 30
Rehabilitation — Why You Drive the Outcome
The evidence that post-operative rehabilitation is the biggest determinant of your result.
Article 31
Going Home — What to Expect in the First Six Weeks
Pain, swelling, sleep, wound care, driving, stairs, and medications.
Article 32
Hip Precautions After THR — What the Evidence Now Says
Hip restrictions — the evidence has shifted. What modern surgery actually recommends.
Article 33
Red Flags After Surgery — When to Act Fast
Signs of infection, clot, dislocation, and fracture — when to act fast.
Article 34
Returning to Sport and Activity After Joint Replacement
Cycling, swimming, golf, tennis, skiing — what the evidence and consensus say.
Article 35
What Is a Good Outcome? Managing Expectations
PROMS, Oxford scores, satisfaction rates, and the honest statistics on pain relief.
6
The Bigger Picture
Choosing your surgeon, understanding data, and looking to the future
7 articles
Article 36
How to Read Your Surgeon’s NJR Profile
The NJR surgeon-level data is public — here is what it actually means.
Article 37
GIRFT — What It Is and What It Found
Getting It Right First Time — the national programme that reshaped joint replacement practice.
Article 38
How to Choose a Surgeon and a Hospital
Practical guidance on using NJR, NHS Choices, and other public data.
Article 39
NHS vs Private — What Does the Evidence Say?
Is there actually a difference in outcomes — and what does the data show?
Article 40
What Is Revision Surgery and How Common Is It?
When joints fail, what happens next — and how to minimise your risk.
Article 41
The Psychology of Chronic Pain and Surgical Outcomes
Central sensitisation, pain catastrophising, and why your mindset affects your outcome.
Article 42
The Future of Joint Replacement — What Is Coming
Robotics, biologics, smart implants, and the emerging role of AI in surgical planning.