Knee Replacement FAQs: Surgery Questions and Answers

Total knee replacement, also called knee arthroplasty, is a surgical procedure that replaces damaged knee surfaces with metal and plastic components. The surgeon removes damaged cartilage and bone, then attaches artificial implants that recreate the knee joint's natural function.

Surgery is typically recommended when severe arthritis causes persistent pain and disability that has not improved with conservative treatments like medications, injections, physical therapy, and lifestyle changes. Most candidates have bone-on-bone arthritis visible on X-rays.

Signs you may need knee replacement include constant knee pain (even at rest), significant limping, inability to walk reasonable distances, knee pain that disrupts sleep, and failure to improve with 6+ months of conservative treatment. Your doctor will evaluate X-rays and symptoms.

Alternatives include physical therapy, weight loss, anti-inflammatory medications, cortisone injections, gel injections (viscosupplementation), bracing, activity modification, and partial knee replacement. Many patients can delay or avoid surgery with these treatments.

The surgery itself typically takes 1-2 hours. Including pre-operative preparation and post-operative recovery room time, expect to be at the hospital for several hours. Most patients stay in the hospital for 1-3 days after surgery.

Most patients walk with assistance within 24 hours of surgery. By 6 weeks, many return to most daily activities. Full recovery takes 3-6 months, with continued improvement up to one year. Following your physical therapy program is essential for best results.

Pain is significant in the first few weeks but manageable with medications. Pain gradually decreases over 6-12 weeks. Modern pain management protocols, including nerve blocks and oral medications, help control discomfort. Most patients say the surgical pain is worth the long-term relief.

Risks include infection (1-2%), blood clots (1-2%), implant loosening, stiffness, nerve damage, and need for revision surgery. Serious complications are uncommon in healthy patients at experienced centers. Your surgeon will discuss your personal risk factors.

Modern knee implants last 15-25 years in most patients, with some lasting even longer. Longevity depends on your activity level, weight, implant type, and surgical technique. About 90% of knee replacements still function well after 15 years.

Partial knee replacement replaces only the damaged portion of your knee rather than the entire joint. It preserves healthy bone and ligaments, allowing faster recovery and more natural movement. It is only suitable if arthritis is limited to one knee compartment.

Age alone does not disqualify you from surgery. Many patients in their 70s and 80s have successful knee replacements. Your overall health, activity level, and ability to participate in rehabilitation matter more than age. Your surgeon will assess your fitness for surgery.

Younger patients (under 60) may be advised to delay surgery because implants eventually wear out and may need revision. However, if severe arthritis significantly impacts quality of life, surgery may be appropriate. Newer implants show improved durability for younger patients.

Many patients can kneel after recovery, though it may feel uncomfortable due to numbness or sensitivity around the incision. About 60-80% of patients can kneel to some degree. Kneeling on a cushion or pad helps. Full kneeling ability varies by individual.

Low-impact activities like walking, swimming, cycling, and golf are encouraged. High-impact activities like running, basketball, and skiing increase wear on the implant and are generally discouraged. Discuss your activity goals with your surgeon before surgery.

The surgeon makes an incision, moves muscles and ligaments aside, removes damaged bone and cartilage, shapes the bone surfaces, and attaches metal components to the thighbone and shinbone. A plastic spacer creates a smooth gliding surface between the metal parts.

Options include general anesthesia (you are asleep) or spinal/epidural anesthesia (you are awake but numb from the waist down). Many surgeons also use nerve blocks for post-operative pain control. Your anesthesiologist will recommend the best option for you.

Total costs range from $30,000 to $60,000 or more, including hospital, surgeon, anesthesia, implant, and rehabilitation. Medicare covers knee replacement when medically necessary, with patients typically paying 20% of approved amounts plus hospital deductibles.

Preparation includes medical evaluation, possibly losing weight, strengthening exercises (prehabilitation), stopping certain medications, arranging home help, and setting up your home for recovery. Your surgical team will provide detailed instructions.

Follow your physical therapy program diligently, walk regularly, manage pain appropriately, eat a healthy diet, stay hydrated, get adequate sleep, and attend all follow-up appointments. Patients who actively participate in rehabilitation recover faster.

Bilateral (both knees) replacement is possible for some patients and reduces total recovery time. However, it carries higher risks and requires excellent overall health. Most surgeons recommend spacing surgeries 3-6 months apart for safety.