Total knee replacement (also called total knee arthroplasty) is one of the most common orthopaedic procedures in the country -- over 700,000 are done each year in the United States. Here's what you should know before, during, and after.
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, activity modification -- haven't provided enough relief
- Pain limits your daily activities, your sleep, or both
- X-rays show bone-on-bone contact in the joint
Most patients are between 50 and 80 years old, though younger patients get the procedure when the situation calls for it.
What's changed in knee replacement surgery
The procedure has come a long way in the last decade:
- Robotic-assisted surgery (MAKO, ROSA) improves implant positioning accuracy
- Less invasive techniques reduce tissue damage and speed up recovery
- Current implant materials last 20-25 years for most patients
- Recovery protocols now get patients walking within hours of surgery
- Some patients go home the same day
The procedure
Total knee replacement takes 1-2 hours. The surgeon removes damaged cartilage and bone from the knee joint and replaces it with metal and plastic implant components. You'll be under regional anesthesia (spinal block) or general anesthesia.
Recovery timeline
- Day 1: Walking with a walker or cane
- Weeks 1-2: Home recovery with physical therapy exercises
- Weeks 3-6: More mobility, less pain medication, outpatient physical therapy
- Months 2-3: Back to most daily activities and driving
- Months 3-6: Continued strengthening; most patients feel fully recovered
- 1 year: Maximum improvement in strength and flexibility
How to choose a knee replacement surgeon
When you're looking for a surgeon:
- Find someone who specializes in joint replacement, not general orthopaedics
- Ask about their annual volume -- higher-volume surgeons tend to have better outcomes
- Ask whether robotic-assisted surgery is available
- Verify they accept your insurance
- Ask about their complication rates and patient satisfaction scores
