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Surgeon clearance needed."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":14,"unit":"days","qualifier":"Approximately 2 weeks after surgery"}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":90,"unit":"days","qualifier":"About 6-12 weeks after surgery, with X-ray as needed"}},{"purpose":"result_review","requirement":"routine","after":{"min":300,"max":400,"unit":"days","qualifier":"Around 1 year after surgery"}}],"indications":["End-stage knee osteoarthritis unresponsive to conservative treatment","Inflammatory arthritis (e.g., rheumatoid) with joint destruction","Post-traumatic arthritis","Avascular necrosis of the knee with joint collapse","Significant knee deformity with pain and disability"],"main_risks":["Infection of the joint or wound","Deep vein thrombosis and pulmonary embolism","Stiffness or limited range of motion","Persistent pain","Implant loosening, wear or instability over time","Bleeding or wound healing problems","Nerve or vessel injury","Periprosthetic fracture","Anesthesia-related and cardiac complications"],"pain":"Moderate to severe pain in the first days to 2 weeks, controlled with multimodal analgesia and nerve blocks; gradually decreasing over 6-12 weeks, with some activity-related discomfort or swelling possible for months.","preparation":["Preoperative medical assessment, blood tests and ECG as indicated","Imaging (weight-bearing X-rays, sometimes CT or MRI)","Optimization of conditions such as diabetes, anemia and blood pressure","Smoking cessation and weight management where relevant","Dental and skin/infection screening","Review of medications and allergies with the surgical team","Fasting before surgery as instructed","Home preparation and pre-habilitation exercises; arrange assistance after discharge"],"recovery_timeline":[{"phase":"Hospital stay (day 0-3)","description":"Mobilization with walker or crutches typically on day of surgery or day 1, pain control, thrombosis prevention and early knee movement.","restrictions":["Walking aid","Elevate leg to control swelling"]},{"phase":"Early recovery (weeks 1-6)","description":"Daily exercises and physiotherapy, wound healing, progressive weight bearing as tolerated, transition from walker to cane.","restrictions":["No driving until cleared","Avoid kneeling and twisting","Avoid prolonged sitting without moving"]},{"phase":"Functional recovery (weeks 6-12)","description":"Walking without aids, strength and range-of-motion improvement, return to desk work and driving.","restrictions":["Avoid high-impact activity","Avoid heavy lifting"]},{"phase":"Late recovery (3-12 months)","description":"Continued strengthening, resolution of swelling and gradual return to low-impact recreation.","restrictions":["Avoid running and jumping sports unless approved by surgeon"]}],"rehabilitation_days":{"min":42,"max":90,"unit":"days","qualifier":"Walking without aids, stairs and self-care return in 6-12 weeks; gains continue up to 12 months."},"result_longevity":"Modern implants commonly last 15-25 years or more in many patients, depending on age, weight, activity level and implant factors.","revision_rate_pct":{"min":3,"max":7,"unit":"percent","qualifier":"Primary total knee replacements revised within about 10 years; partial replacement higher, roughly 10-15%."},"scars":"A single vertical anterior midline scar over the knee, typically 12-20 cm, fading over a year; smaller for minimally invasive approaches.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One operation for a unilateral primary total knee replacement."},"stages":[{"code":"surgery","label":"Total knee replacement operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery"}}],"qualifier":"Single-stage unilateral primary total knee replacement; bilateral surgery is a separate scope."},"success":{"metric":"Implant survivorship (freedom from revision for any reason)","value":95,"unit":"percent","horizon":"10 years","evidence_status":"proven","population":"Adults after primary total knee replacement for osteoarthritis"},"techniques":[{"name":"Total knee replacement (conventional instrumentation)","suits_whom":"Most patients with advanced tricompartmental knee arthritis","recovery":"Standard recovery as described, about 6-12 weeks to functional recovery."},{"name":"Robotic-assisted or navigated total knee replacement","suits_whom":"Patients and surgeons favoring computer-assisted implant positioning accuracy","recovery":"Broadly similar to conventional recovery."},{"name":"Unicompartmental (partial) knee replacement","suits_whom":"Selected patients with arthritis confined to one compartment and intact ligaments","recovery":"Often faster, with shorter stay and quicker mobilization."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Operating time for a unilateral primary total knee replacement; excludes anesthesia and recovery room time."},"initial_assessment_documents":["Knee X-ray images and radiology reports","Knee MRI or CT images, if done","Recent blood test and ECG results","Recent orthopedic report or clinic notes","Current medication list including blood thinners","Prior knee surgery operative reports, if any"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; hospital stay 1-3 nights, return flight usually 2-6 weeks after surgery. Later reviews can be done remotely."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how many of these procedures the surgeon performs each year","scope":"procedure","source":{"url":"https://www.orthoinfo.org/en/treatment/total-joint-replacement-questions-patients-should-ask-their-surgeon","host":"orthoinfo.org","quote":"How many do you perform each year?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Ask how many total hip or knee replacements the hospital or surgery center performs per year","scope":"procedure","source":{"url":"https://www.orthoinfo.org/en/treatment/total-joint-replacement-questions-patients-should-ask-their-surgeon","host":"orthoinfo.org","quote":"How many total hip or knee replacements does your hospital or surgery center perform per year?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Ask about the major and most frequent complications after the operation","scope":"procedure","source":{"url":"https://www.orthoinfo.org/en/treatment/total-joint-replacement-questions-patients-should-ask-their-surgeon","host":"orthoinfo.org","quote":"What are the major and/or most frequent complications following surgery?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Check whether you are satisfied with the facility's standards","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C6","text":"Confirm how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C7","text":"Confirm you can ask the treating team your questions directly","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"New numbness or weakness","urgency":"contact_clinic","general":false,"source":{"url":"https://www.aaos.org/pain/patients-and-caregivers/","host":"aaos.org","quote":"You should also ask for help if you notice signs of infection, new numbness or weakness, uncontrolled swelling, or symptoms that feel unusual for your recovery.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"W2","text":"Uncontrolled swelling","urgency":"contact_clinic","general":false,"source":{"url":"https://www.aaos.org/pain/patients-and-caregivers/","host":"aaos.org","quote":"You should also ask for help if you notice signs of infection, new numbness or weakness, uncontrolled swelling, or symptoms that feel unusual for your recovery.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"W3","text":"Severe trouble breathing","urgency":"emergency","general":false,"source":{"url":"https://www.aaos.org/pain/patients-and-caregivers/","host":"aaos.org","quote":"Call emergency services right away for severe trouble breathing, extreme sleepiness, confusion, chest pain, or other urgent symptoms.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"W4","text":"Pain getting worse instead of better","urgency":"contact_clinic","general":true,"source":{"url":"https://www.aaos.org/pain/patients-and-caregivers/","host":"aaos.org","quote":"Contact your care team if your pain is getting worse instead of better, your medicine is not helping, you have troubling side effects, or you are unsure how to take or taper your medication.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives your home doctor treatment details and future care needs","document":"letter for your home doctor","source":{"url":"https://www.nhs.uk/nhs-services/hospitals/going-into-hospital/being-discharged-from-hospital","host":"nhs.uk","quote":"You'll also be given a letter for your GP, providing information about your treatment and future care needs.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Confirms you have a joint replacement, which later clinicians should know","document":"joint replacement id card","source":{"url":"https://webflow-prod.cedars-sinai.org/health-topics/fly-through-airport-security-with-your-new-joint","host":"webflow-prod.cedars-sinai.org","quote":"These cards identify the holder of the card as having a joint replacement.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You prefer a nonsurgical treatment such as exercise","name":"Exercise therapy for knee arthritis","source":{"url":"https://www.nhs.uk/conditions/osteoarthritis/treatment/","host":"nhs.uk","quote":"Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200},"operation_id":null},{"id":"A2","text":"Other treatments have not relieved your knee arthritis pain","name":"Steroid injections for knee 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bone","source":{"url":"https://www.orthoinfo.org/en/treatment/robotic-assisted-joint-replacement","host":"orthoinfo.org","quote":"The robotic instruments provide sensory feedback to assist the surgeon in precisely removing damaged bone.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"unicompartmental-knee","name":"Unicompartmental (partial) knee replacement","how_it_works":{"text":"Only one area of the knee is resurfaced","source":{"url":"https://www.orthoinfo.org/en/treatment/unicompartmental-knee-replacement","host":"orthoinfo.org","quote":"In unicompartmental knee replacement, only one area of the knee is resurfaced.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":6,"max":6,"unit":"weeks","label":"6 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