Total knee replacement surgery removes damaged cartilage and bone from the knee joint and replaces it with an artificial joint called a prosthesis.

Your doctor may recommend a total knee replacement when knee pain and loss of function become severe, and medicines and other treatments no longer relieve pain.

Total knee replacement surgery is not recommended for people who:

  • Have poor general health and may not tolerate anesthesia and surgery well
  • Have an active infection or are at risk for infection
  • Have osteoporosis (significant thinning of the bones)
  • Have severe weakness of the quadriceps muscles at the front of the thigh
  • Have a knee that appears to bend backward when the knee is fully extended (genu recurvatum), if this condition is due to muscle weakness or paralysis
  • Are severely overweight (replacement joints may be more likely to fail in people who are very overweight)

Total knee replacements are also not ideal for people who are younger or do strenuous work. An artificial knee joint is more likely to wear out in these patients than in an older or less active person.

If you are a younger patient, you may be a candidate for partial knee resurfacing.

What Happens During Total Knee Replacement Surgery?

During total knee replacement surgery, your orthopaedic surgeon replaces damaged bone and cartilage in a step-by-step process:

  • Knee replacement surgeons often replace the entire surface at the ends of the thigh and lower leg bones.
  • Surgeons cap the end of these damaged bones, as well as the kneecap, with artificial surfaces lined with metal and plastic.
  • Surgeons usually secure knee joint components to the bones with cement.
  • Surgeons remove the damaged cartilage and replace it with new joint surfaces.

Most patients are under general anesthesia for joint replacement surgeries. That means you'll be unconscious during the surgery. Regional anesthesia – which only numbs the knee area and keeps you awake, but sleepy – may be an option for some patients.

Recovery Process

Most patients go home a few days to a week after total knee replacement surgery. Your doctor may want to see you for regular visits for several months or more to monitor your knee replacement.

Rehabilitation (rehab) after a total knee replacement is intensive. You will work with a physical therapist during your hospital stay, and continue with an exercise program after you return home.

Some patients may need to go to a specialized rehab center for more treatment. Total rehab after surgery will take several months.

Most people start to walk with a walker or crutches the day after surgery and can bear weight on the knee if it is comfortable. After you go home, your doctor may recommend:

  • Taking a short walk several times each day
  • Riding a stationary bicycle to strengthen your leg muscles and improve your knee bending
  • Swimming

Living With a Total Knee Replacement

Most people have much less pain after total knee replacement surgery and are able to do many of their daily activities more easily. Here’s what you can expect:

  • The knee will not bend as far as it did before you developed knee problems, but the surgery will allow you to stand and walk for longer periods without pain.
  • You may be allowed to resume activities such as golfing, riding a bike, swimming, walking for exercise, dancing or cross-country skiing (if you did these activities before surgery).
  • Your doctor may discourage you from running, playing tennis, squatting and doing other things that put a lot of stress on the joint.

Joint Replacement Program

We offer one of the most comprehensive joint replacement programs in the Winston-Salem area. From minimally invasive to bone-sparing procedures, our full menu of surgical options fits patients of all ages and activity levels.

Our orthopaedic teams include surgeons who are highly trained specialists in their fields. That means they focus on diagnosing and treating problems in only one region of the body, such as the knees, hips or shoulders.