Total Knee Replacement - What to Expect

Dr. John Frauens retired in 2010 as director of adult reconstructive surgery at the Kaiser Medical Center in Honolulu, Hawaii. Dr. John Frauens served in this role for 25 years, during which time he performed more than 3,000 hip and knee replacements.

Since the procedure was first introduced 50 years ago, knee replacement surgery has provided relief for numerous patients with disabling knee pain due to osteoarthritis, rheumatoid arthritis, and other degenerative conditions or deformities. The procedure is often recommended for patients whose discomfort or stiffness severely limits everyday activities and has not responded to more conservative treatment.

To perform a total knee replacement, a surgeon positions the knee so that he or she can access all joint surfaces. Then, after making a 6- to 10-inch incision, the surgeon displaces the kneecap and removes damaged cartilage and bone surfaces. He or she replaces those damaged surfaces with metal implants, which may be attached with or without surgical cement.

In some cases, the next step is to cut and resurface the underside of the patella. Whether this is done depends on the patient's presentation and needs. Finally, the surgeon places a plastic spacer between the metal components to allow the knee to bend and straighten smoothly.

The procedure itself takes approximately two hours. The patient's total hospital stay usually lasts for several days, during which time the patient begins physical therapy to strengthen the new knee. Physical therapy continues after the patient goes home.

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