Knee replacement, also called knee arthroplasty, replaces the worn-out parts of your knee joint with artificial materials.

People usually get knee replacement surgery because they have severe arthritis in their knee joint. Arthritis attacks the cartilage in your knee. Without healthy cartilage, your knee can’t move as it should.

First, the surgeon removes your damaged cartilage and some of the bone. How much they remove depends on how severe the damage is.

Then, using metal and plastic parts, they recreate your knee joint. After knee replacement surgery, your knee moves like a normal knee.

Knee replacement surgery is elective, meaning you decide yourself if you want it. Because it helps people get mobility back, it’s one of the most successful surgeries in all of medicine.

The most common reason people need knee replacement is osteoarthritis, or “wear and tear” arthritis. This is a progressive condition, meaning that it gets worse over time.

When you have arthritis, you don’t need a knee replacement when it first starts to hurt. To treat the pain, you and your orthopaedic doctor will try other treatments first, including:

• Medicine: Medical treatments include over-the-counter and prescription anti-inflammatories and medicines to manage pain
• Pain injections: Steroid injections right into your knee joint can help you manage pain for months at a time
• Physical therapy (PT): PT can help stretch and strengthen the muscles that stabilize your knee joint

You might be a good candidate for knee replacement if you’ve tried these treatments and still have: 

• Severe knee pain limiting your everyday movement such that you can’t walk more than a few minutes or climb stairs without pain
• Inflammation and swelling in your knee that isn’t getting better
• Knee pain that happens while resting, making it difficult to sleep

Once you decide to have knee replacement surgery, you’ll attend Joint Academy at Carilion. This is a class that helps you prepare for surgery and know what to expect.

The healthier and stronger you are before surgery, the better your recovery will be. At the class, you’ll learn things like:

• Foods you should eat before surgery and during recovery
• “Pre-hab” exercises to do before surgery
• What to expect with physical therapy after surgery
• Tests you need before surgery
• How to set up your home for success after surgery

Day of surgery

For knee replacement, you’ll either have general anesthesia (being asleep) or regional anesthesia (being awake). Your surgical team will talk to you about which is best for you.

Knee replacement surgery usually takes 1 to 2 hours.

You might be a candidate for same-day knee replacement surgery. This means you go home the day of surgery and start your recovery at home. You’ll need someone with you who can take you home.

Your team will make sure you have what you need to manage your pain after surgery. You’ll need someone at home to help care for you for at least the first week after surgery.

Recovery

Whether you're going home or spending the night after surgery, your care team will get you up and moving shortly after your operation. You’ll learn specific physical therapy exercises to do on your own right away.

Your doctor will give you a set of post-surgery instructions to follow. This will cover how to care for your incision and any warning signs to look for.

You’ll also work with a physical therapist on a rehab program. You’ll have PT at home for the first few days. Then you’ll go to an outpatient PT location.

You should be able to get back to most of the activities of daily living 3 to 6 weeks after surgery. Your physical therapist will work with you to build up your strength and slowly increase your mobility.

All surgeries come with risks. For joint replacement, the ones we’re most concerned about are:

• Infection: If bacteria settle on your artificial knee joint, it can become infected. The replacement parts can’t fight off germs the way your own body parts can. You may need to take antibiotics after surgery. Fever, chills, increasing redness or swelling around the joint are all signs of infection.
• Blood clots: If a blood clot forms in your leg, it can break off and travel to your lungs. This is a life-threatening condition. It’s why your doctor will likely have you take blood thinning medicine after surgery.
• Falls after surgery: A fall in the weeks after surgery can delay your recovery and even cause you to need another surgery. Your care team will talk to you about how to prevent falls after surgery.