Regional (spinal or epidural) anesthesia. You will be numb below your waist. You will also get medicines to make you relax or feel sleepy.
The surgeon will make a cut over your knee. This cut is about 3 to 5 inches long.
Next, the doctor looks at the entire knee joint. If there is damage to more than one part of your knee, you may need a total knee replacement. Most of the time this is not needed, because tests done before the procedure would have shown this damage.
The damaged bone and tissue are removed.
A part made from plastic and metal is placed into the knee.
Once the part is in the proper place, it is attached with bone cement.
The wound is closed with stitches.
Why the Procedure Is Performed
The most common reason to have a knee joint replaced is to ease severe arthritis pain.
Your doctor may suggest knee joint replacement if:
You can't sleep through the night because of knee pain.
Your knee pain prevents you from doing daily activities.
Your knee pain has not gotten better with other treatments.
Ask your doctor which medicines you can still take on the day of your surgery.
You may be asked to stop taking medicine that makes it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin), and other drugs.
You may need to stop taking any medicines that weaken your immune system, including Enbrel and methotrexate.
If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.
Tell your doctor if you have been drinking a lot of alcohol (more than one or two drinks a day).
If you smoke, you need to stop. Ask your doctor or nurse for help. Smoking slows healing and recovery.
Let your doctor know if you get a cold, flu, fever, herpes breakout, or other illness before your surgery.
You may want to visit a physical therapist before surgery to learn exercises that can help you recover.
You can put your full weight on your knee right away.
After you return home, you should try to do as much as you can. This includes going to the bathroom or taking walks in the hallways with help. You will also need physical therapy to improve range of motion and strengthen the muscles around the knee.
Most people recover quickly and have much less pain than they did before surgery. People who have a partial knee replacement recover faster than those who have a total knee replacement.
Many people are able to walk without a cane or walker within 3 to 4 weeks after surgery. You will need physical therapy for 4 to 6 months.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.