Total knee replacement (also called total knee arthroplasty) is one of the most successful procedures in modern medicine, with over 700,000 performed annually in the United States. This guide covers what patients should know before, during, and after the procedure.
Who Needs a Knee Replacement?
Knee replacement is typically recommended when:
- Severe arthritis (usually osteoarthritis) has destroyed the cartilage in your knee joint
- Conservative treatments — physical therapy, anti-inflammatory medications, injections, and activity modification — have failed to provide adequate relief
- Pain significantly limits your daily activities, sleep, or quality of life
- X-rays show bone-on-bone contact in the joint
Most knee replacement patients are between 50 and 80 years old, though the procedure is performed on younger patients when appropriate.
Modern Advances in Knee Replacement
Knee replacement surgery has evolved significantly:
- Robotic-assisted surgery (MAKO, ROSA) improves implant positioning accuracy
- Minimally invasive techniques reduce tissue damage and speed recovery
- Improved implant materials last 20-25 years for most patients
- Enhanced recovery protocols get patients walking within hours of surgery
- Outpatient options allow some patients to go home the same day
The Procedure
Total knee replacement surgery typically takes 1-2 hours. The surgeon removes damaged cartilage and bone from the knee joint and replaces it with metal and plastic implant components. The procedure is performed under regional anesthesia (spinal block) or general anesthesia.
Recovery Timeline
- Day 1: Walking with assistance (walker or cane)
- Weeks 1-2: Home recovery with physical therapy exercises
- Weeks 3-6: Increased mobility, reduced pain medication, outpatient physical therapy
- Months 2-3: Return to most daily activities and driving
- Months 3-6: Continued strengthening; full recovery for most patients
- 1 year: Maximum improvement in strength and flexibility
How to Choose a Knee Replacement Surgeon
When selecting a surgeon for knee replacement:
- Look for a surgeon who specializes in joint replacement (not general orthopaedics)
- Ask about their annual volume — higher-volume surgeons tend to have better outcomes
- Inquire about robotic-assisted options if available
- Verify they accept your insurance plan
- Ask about their complication rates and patient satisfaction scores