Total Knee Replacement
A total knee replacement is more than an operation - it’s a pathway back to mobility, independence, and participation in the life you want to live.
With modern surgical techniques, advanced implant designs, and structured rehabilitation, the great majority of patients are highly satisfied with their outcomes.
What is total knee replacement surgery?
A total knee replacement (also known as total knee arthroplasty) is a surgical procedure that replaces the damaged surfaces of the knee with artificial implants. These implants are carefully designed to mimic the movement, smoothness, and stability of a healthy knee joint.
During the procedure, the worn-out cartilage and bone on the ends of the femur (thighbone), tibia (shinbone), and sometimes the back of the patella (kneecap) are removed. These are replaced with metal and highly durable plastic components which glide smoothly against each other, relieving pain and restoring movement.
The aim of knee replacement is not only to take away pain, but also to give you back mobility, independence, and confidence in your daily life—from walking pain-free to kneeling in the garden or playing with grandchildren.
Indications for total knee replacement
You may be a candidate if knee pain has reached the point of interfering with routine life:
Difficulty walking, climbing stairs, or standing for longer than a few minutes
Night pain disturbing sleep
Needing regular strong pain medication
Stiffness that limits your ability to bend or straighten your knee
Loss of independence and reduction in your quality of life
The most common reason is advanced osteoarthritis, but surgery may also be required in cases of rheumatoid arthritis, post-traumatic arthritis, or significant deformity. Surgery is typically considered once non-surgical measures—such as medications, injections, physiotherapy, and lifestyle changes—have not provided sufficient relief.
What is involved in knee replacement surgery?
Every step of a knee replacement is performed with precision to ensure the best long-term result.
1. Incision & exposure
A straight incision is made down the front of the knee.
The kneecap is moved to one side so that the joint surfaces can be accessed.
2. Bone preparation
Damaged cartilage and a thin portion of underlying bone are removed from the ends of the femur, tibia, and sometimes the patella.
In many cases, robotic assistance is used to achieve highly accurate bone cuts and optimal alignment of the implants.
3. Implantation
Artificial components, usually made from cobalt-chromium or titanium, are precisely fitted to recreate the joint surfaces.
A medical-grade polyethylene (plastic) spacer is placed between the components to provide smooth, durable movement.
The back of the kneecap may also be resurfaced with a plastic button if needed.
4. Balancing and alignment
The new joint is moved through its range of motion to check that it is smooth, stable, and well-balanced.
Adjustments are made to ensure that the load is evenly spread across the knee and that the soft-tissues are tensioned correctly.
Your Recovery & Follow-Up Schedule
What to expect during your Recovery from knee replacement surgery
Hospital stay: Most patients go home within 1–4 days.
Rehabilitation: Physiotherapy starts immediately—first with getting in and out of bed, then walking with aids, followed by strengthening exercises to restore movement.
Pain relief: We use a multimodal approach—nerve blocks, local anaesthetic, and tailored medications. Most patients are off strong painkillers within 2 weeks, often managing comfortably with anti-inflammatories or simple analgesics.
Timeline: Significant pain relief usually occurs within 6 weeks, with ongoing improvement in strength and stamina for up to 12 months. Built for longevity, over 90% of modern implants will still be functioning well at 20 years.
Recovery is a gradual process, with milestones that guide your progress:
2 weeks: Wound check and removal of dressings. Most patients walk unaided or with a single stick at this point. Dissolving sutures mean there are no stitches to remove.
6 weeks: You should be off strong pain medication, walking comfortably, and achieving more than 90 degrees of knee bend. Many patients have resumed driving and work.
3 months: An alignment X-ray is performed to confirm joint positioning. Daily activities should be much easier, walking distances longer, and confidence with the new knee improved.
12 months: Most patients enjoy a pain-free knee with excellent mobility and strength. Another X-ray confirms stability of the implant.
Long-term: If all is progressing well, follow-up is scheduled every 5 years with an X-ray to monitor implant stability. Modern implants last 20+ years in the majority of patients.
Frequently Asked Questions
What are the risks of Knee Replacement Surgery?
Knee replacement surgery is generally safe but, like any major procedure, it carries risks. These include:
Blood clots: in the leg veins, which can travel to the lungs (pulmonary embolism). This risk can be reduced by early movement, blood thinners, and compression devices.
Infection: a rare but serious complication which is minimized by sterile surgical techniques and antibiotics. If you are concerned about an infection, please call the rooms and do not start antibiotics until speaking with Mr. Kirzner
Postoperative pain and stiffness: this can often be managed with medication and physiotherapy. Occasionally this may require further surgery for manipulation or arthroscopic release
Implant problems: loosening, wear, or rarely, mechanical failure may occur over time, sometimes requiring revision surgery, although modern implants are very durable.
Nerve or blood vessel injury: though this is uncommon, nerve or blood vessels around the knee can be injured during surgery.
Dissatisfaction or ongoing pain: Previous studies quote a 10-20% rate of dissatisfaction with total knee replacement surgery. Thankfully with appropriate indications, patient selection, expectation setting and modern technologies and techniques, satisfaction rates have improved.
Patients younger than 55 have the least satisfaction after knee replacement, higher expectations and demands is a big element of this.
Numbness and difficulty kneeling: the incision for knee replacement surgery can damage the small nerves around the front of your knee causing numbness on the outside/lateral aspect of your scar. Some patients report difficulty kneeling, however this can be worked on with exercises to desensitise and use of padding to assist. If you regularly kneel for work or recreation, a lateral incision can be performed to decrease this issue.
We will go through your personal risk profile and ensure that every step is taken to minimise complications and maximise success. The fitter and stronger you are prior to your surgery, the safer and quicker your recovery will be and the more you will get out of your knee.
Does a Knee Replacement Feel Like a Normal Knee?
A knee replacement can significantly reduce pain and improve function, but it usually does not feel exactly like a natural knee. Some patients describe it as feeling heavier or noticing subtle clicks. These sensations are normal.
How Long Will the Swelling Last?
Swelling is normal and may last several weeks, gradually improving; mild swelling can persist for several months after surgery. If swelling abruptly worsens or does not steadily improve, consult a doctor.
Will I Need Hospital-Based Rehabilitation?
This depends on individual needs, age, and recovery rate. Many people begin rehab in hospital and then continue as an outpatient or with home exercises; some may need a short inpatient rehabilitation stay if extra support is required.
Will it Set Off the Metal Detector at an Airport?
Yes, it's possible that the metal components in a knee replacement will set off airport metal detectors. Be proactive and advise the security guards that you have had a knee replacement. Wear clothing where the knee incision can easily be shown to the security staff. Having a letter or medical certificate will not prevent these security measures.
Will My Knee Look Different After the Replacement?
Depending on your level or arthritis and deformity, your knee may appear straighter than before and also may be 3-4mm longer. With time the majority of patients adjust to any difference.
When Can I Drive After a Knee Replacement?
To drive you will need to be off all strong pain relief and crutches and have the ability to perform an emergency stop safely. For most patients this is 3 weeks for a left knee (automatic car) and 4-6 weeks for a right knee.
When Can I Fly After a Knee Replacement?
Short flights are often safe within a few weeks after surgery, but longer flights may increase the risk of blood clots. In general, precautions like compression stockings and in-seat exercises are recommended for several weeks.
When Can I Swim After a Knee Replacement?
Participating in pool-based rehabilitation or swimming is not recommended for 4 weeks after your operation as it may increase the risk of infection.
Do I Need Antibiotics After a Knee Replacement for Dental Work?
For the first 3 months following a knee replacement you should be given antibiotics by your dentist if you require urgent dental work. This is to prevent bacteria from your mouth entering your bloodstream and travelling to the knee joint.
After 3 months routine antibiotics are not required for dental work unless your immune system is compromised. If you are in doubt, please get your dentist to contact us prior to your dental procedure.
Will I be able to return to sport?
Most patients return to low-impact activities like walking, cycling, golf, swimming, and hiking. Running and other high-impact sports are not recommended due to wear risk.
Is the surgery painful?
We use a multimodal pain control approach, including local anaesthetic, nerve blocks, and tailored medication. Pain is usually well managed, and many patients describe it as far less painful than they expected. Most patients are discharged on medications no stronger than paracetamol and ibuprofen.
Is it normal to hear clicking in the new knee?
A clicking or tapping sound, especially early on, can be heard from the metal and plastic components tapping on each other. This is usually normal and not a cause for concern.
