Introduction to Knee Replacement
Knee replacement surgery, also known as knee arthroplasty, is a highly effective procedure designed to relieve pain and restore function in patients suffering from severe arthritis of the knee joint. The most common reason for needing knee replacement is osteoarthritis, a condition that wears away the articular cartilage and causes the bones in the knee to rub together, resulting in pain, stiffness, and limited movement. During knee replacement surgery, the damaged knee joint is replaced with a prosthetic knee joint—an artificial joint made from durable materials—to help relieve pain and improve mobility. This replacement surgery is one of the most frequently performed orthopedic procedures, with over 100,000 knee replacement operations carried out each year in the UK alone. For most patients, especially those undergoing total knee replacement surgery, the procedure offers significant improvements in quality of life and the ability to perform everyday activities.
How Long Does Knee Replacement Surgery Take?
The actual knee replacement operation typically takes between 1 and 2 hours. However, the total time spent at the hospital—including preoperative preparation, anesthesia, and recovery room monitoring—can be 4 to 6 hours or longer.[1]
- Preoperative preparation: 30–60 minutes (anesthesia, positioning, sterilization)
- Surgical procedure: 60–120 minutes (for a full knee replacement, this involves removing and replacing the entire knee joint, including removal of damaged bone/cartilage, placement of prosthesis, closure)
- Recovery room: 1–2 hours (monitoring vital signs, pain control, initial movement)
- Mini incision surgery (MIS): This minimally invasive option uses a smaller incision and specialized instruments, which may reduce tissue damage and speed up recovery for some patients.
Complex cases, revision surgeries, or patients with additional health conditions may require more time. Revision surgery (repeat knee replacement) is more complex and often takes longer to perform, with a longer recovery period.
What Happens During Knee Replacement Surgery?
- Anesthesia: General or spinal anesthesia is administered for comfort and pain control.
- Incision: A cut is made over the knee to access the joint.
- Removal: Damaged cartilage and bone are removed from the thigh bone (femur), shin bone (tibia), and sometimes the knee cap (patella).
- Implantation: Metal and plastic prosthetic components are placed to create a new knee joint, and bone cement is often used to secure these components in place.
- Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
Most patients begin gentle movement and physical therapy within 24 hours of surgery to promote healing and prevent complications.
Types of Knee Joint Replacement
There are several types of knee replacement surgery, each tailored to the patient’s specific needs and the extent of knee damage. The most common is total knee replacement, or total knee arthroplasty, which involves replacing the entire knee joint with an artificial knee joint. For some patients, a partial knee replacement—also known as unicompartmental knee replacement—may be appropriate. This procedure replaces only the damaged portion of the knee, preserving healthy bone and tissue. Other options include kneecap replacement, which focuses on replacing only your kneecap if that is the source of pain, and revision knee replacement, which is performed when a previous artificial knee joint needs to be replaced due to wear, loosening, or other complications. The choice between these types of replacement surgery depends on factors such as the severity of joint damage, patient age, activity level, and overall health.
Knee Implants and Materials
Knee implants used in knee replacement surgery are engineered from high-quality materials to ensure durability and smooth movement. Most knee replacements feature a combination of metal and plastic parts, with the artificial knee joint typically made from metal alloys such as cobalt-chromium, titanium, or nickel, paired with medical-grade plastics and polymers. These materials are chosen for their strength, compatibility with the body, and ability to mimic the natural movement of the knee joint. The longevity of knee implants varies, but most knee replacements last between 15 and 20 years, depending on factors like patient activity level, weight, and overall health. Advances in implant technology continue to improve the performance and lifespan of artificial knee joints, making knee replacement a reliable solution for long-term pain relief and improved mobility.
Joint Replacement Options
Patients considering knee replacement surgery have several joint replacement options, depending on the extent of knee damage and individual needs. Total knee replacement is the most common, involving the replacement of the entire knee joint with an artificial knee joint. Partial knee replacement is a less invasive alternative, replacing only the affected compartment of the knee and preserving healthy tissue. For those who have previously undergone knee replacement, revision knee replacement surgery may be necessary if the original artificial knee joint becomes worn or problematic. In some cases, knee arthroscopy—a minimally invasive procedure using a small camera and instruments—can be used to repair or replace damaged cartilage, potentially delaying the need for a full joint replacement. Each option is tailored to relieve pain, restore function, and improve quality of life for patients with knee joint problems.
Risks and Complications
While knee replacement surgery is generally safe and effective, it is still considered major surgery and carries certain risks and potential complications. Some of the most common risks include infection, blood clots in the leg veins, and severe pain following the procedure. Patients may also experience unusual bone growth around the artificial joint, known as heterotopic ossification, or wear and tear on the implant that could require further surgery. Other possible complications include issues related to spinal or epidural anaesthetic, as well as unexpected bleeding during the operation. Despite these risks, most knee replacement patients recover well, especially when they follow their orthopaedic surgeon’s instructions and attend all recommended follow-up appointments. Early detection and management of complications are key to ensuring a successful outcome and long-term pain relief.
Case Study: Successful Knee Replacement and Recovery
A 68-year-old patient with severe knee pain and osteoarthritis underwent total knee replacement, a common and highly effective procedure for treating advanced knee arthritis. The surgery lasted 90 minutes, and the patient was up and walking with a physical therapist using a walking frame the next day. After 6 weeks of physical therapy and home exercises, the patient regained full mobility and reported a 90% reduction in pain. This case highlights the importance of early rehabilitation and a comprehensive recovery plan.
What Is the Recovery Timeline After Knee Replacement?
- Hospital stay: 1–3 days (some centers offer same-day discharge for select patients; marks the beginning of the recovery period)
- Initial recovery: 2–6 weeks (pain, swelling, and stiffness gradually improve; use of walker or cane as needed; scar tissue healing during this time may limit certain activities such as kneeling or exercising)
- Physical therapy: Begins immediately and continues for 6–12 weeks or longer, with a focus on improving knee motion—such as achieving 90 to 110 degrees of flexion—to support functional recovery
- Pain and swelling management: Use of pain medication, including narcotics and anti-inflammatories, is important to control pain, reduce swelling, and enable early mobilization during the recovery period
- Return to normal activities: Most patients resume everyday tasks within 6–12 weeks as part of knee replacement surgery recovery; full recovery may take 3–6 months depending on job type and other factors
Factors such as age, overall health, and adherence to rehabilitation can influence recovery speed and outcomes.[2]
How to Prepare for Knee Replacement Surgery
- Discuss all medications and supplements with your surgeon
- Arrange for help at home during the first few weeks of recovery
- Prepare your home for safety (remove tripping hazards, install handrails, set up a comfortable recovery area)
- Follow preoperative instructions regarding fasting, bathing, and medication adjustments
- Maintain a healthy diet and stay as active as possible before surgery
These preparation protocols are based on guidelines from organizations dedicated to health and care excellence, such as NICE, to ensure the highest standards and best practices are followed.
Treatments for Knee Pain Before and After Surgery
Conservative Treatments
- Physical therapy: Exercises to strengthen muscles and improve joint flexibility
- Pain management: NSAIDs, acetaminophen, or topical creams for pain relief
- Weight management: Reduces stress on the knee and improves surgical outcomes
- Assistive devices: Braces, canes, or walkers for support
- Lifestyle changes: Regular exercise, balanced diet, and stress management
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat knee pain.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with knee pain.
As prolotherapy is helping to treat the root cause of knee pain, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Other Interventions
- Corticosteroid injections: For severe pain or inflammation in the knee
- Hyaluronic acid injections: To lubricate the joint and reduce pain
- Surgery: Knee replacement or repair for advanced arthritis not responding to conservative care. Other surgical options include anterior cruciate ligament (ACL) reconstruction, which typically takes 1–2 hours and may require an overnight hospital stay. Keyhole surgery (arthroscopy) is a minimally invasive procedure that often allows for faster recovery, less post-operative pain, and a quicker return to daily activities compared to traditional surgery. After surgery, patients are often advised to wear compression stockings to help prevent blood clots.
Frequently Asked Questions
How long does knee replacement surgery take?
The procedure itself usually takes 1–2 hours, but the total hospital time is 4–6 hours including preparation and recovery.[1]
How soon can I walk after knee replacement?
Most patients begin walking with assistance within 24 hours of surgery, guided by a physiotherapist.
Is prolotherapy safe for knee pain?
Prolotherapy is considered safe when performed by a qualified practitioner and has shown promising results for knee pain and function.[3]
How long is the recovery after knee replacement?
Most people return to normal activities within 6–12 weeks, but full recovery can take 3–6 months.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating knee pain, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with knee pain and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
References
- NHS. (2023). Knee replacement surgery. https://www.nhs.uk/conditions/knee-replacement/
- American Academy of Orthopaedic Surgeons. (2023). Total Knee Replacement. https://orthoinfo.aaos.org/en/treatment/total-knee-replacement/
- Rabago, D., et al. (2016). Prolotherapy in Primary Care Practice. Primary Care: Clinics in Office Practice, 43(2), 329-338. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913113/
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.