Decrease font size Increase font size Change Text Size Send this page to a friend Share this page

Knee Pain

Frequently Asked Questions

What is total knee replacement?

Also called arthroplasty, total joint replacement is a surgical procedure in which both sides of a joint are removed and replaced by artificial implants (prostheses) that are anchored to the bones.

How are joint pain and stiffness related to arthritis?

In osteoarthritis (OA), the soft, movement-easing cartilage at the ends of joint bones breaks down and wears away as the person grows older. Eventually the bones rub directly against each other whenever the joint moves, causing pain and stiffness. The rest of the body's joint surfaces are covered with a smooth tissue lining called the synovium: In rheumatoid arthritis (RA), chemical changes in the synovium cause it to destroy cartilage. In post-traumatic arthritis, joint pain and stiffness may develop after injury to the joint; the resulting failure of the bone and cartilage to heal properly causes the roughened joint surfaces to grind together.

How "bad" does my joint pain have to get before I should consider having total knee replacement surgery?

This is a very personal decision that only you can make with the help of an orthopaedic surgeon's evaluation of your pain and its effects on your daily life. For helpful insights into whether now may be the time for you to consider joint replacement, take our quick Self-Test: Should You Consider Joint Replacement? or read the article, Learn When to Consider Joint Replacement.

Why do some people need joint replacement?

When other treatment options no longer provide relief, joint replacement may be recommended — not only to relieve pain but also to prevent the disability it can cause. For example, experiencing joint pain day after day without relief can lead to "staying off" the joint — which often weakens the muscles around it so it becomes even more difficult to move. Your orthopaedic surgeon will tell you whether you might benefit from joint replacement and explain the reasons why it may, or may not, be right for you at this time. To prepare for this important discussion, go to: 10 Questions to Ask your Doctor.

Will an artificial knee last forever?

As successful as most of these procedures are, over the years, the artificial joints can become loose and unstable or wear out, requiring a revision (repeat) surgery. These issues, together with the fact that increasing numbers of younger and more active patients are receiving total joint replacement, and patients are living longer, have challenged the orthopaedic industry to try to extend the life cycle of total joint replacements.

What is MIS Knee Joint Replacement?

MIS Knee Joint Replacement is considered a step forward in total knee replacement for a number of reasons, which include the following: potential for a shorter hospital stay, faster recovery, and less scarring.

The MIS Knee Joint Replacement procedure is an advancement in total knee replacement that offers important advantages over the standard surgical procedure. This technique brings together high quality knee implants, new minimally invasive surgical techniques, and new instrumentation.

What are the advantages of MIS surgery?

Because fewer muscles and tendons are disturbed with MIS Knee Joint Replacement, wound closure may be easier, and recovery may be faster. Over the past 25 years, minimally invasive surgery has revolutionized many fields of medicine. Its key characteristic is that it uses specialized techniques and instrumentation that enable the physician to perform major surgery without a large incision. In this respect, MIS Knee Joint Replacement is indeed "minimally invasive," requiring a smaller incision and causing less trauma to the soft-tissues. Minimally invasive surgical techniques may offer potential benefits including less pain, less recovery time, and potential for less scarring.

What are the risks associated with MIS surgery?

The MIS Knee Joint Replacement technique is significantly less invasive than conventional TKR, but it is still a total knee replacement, not a partial or unicompartmental knee replacement. While the MIS technique requires additional time to complete, it may result in advantages for the patient. Joint replacement surgery is a major surgery and significant complications, while rare, can occur.

As with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications, the vast majority of which can be successfully avoided and/or treated. In fact, the complication rate following joint replacement surgery is very low: Serious complications, such as joint infection, occur in less than 2% of patients. (Besides infection, possible complications include blood clots and lung congestion, pneumonia, or death.)

How can I find an orthopaedic surgeon near me?

You can find an orthopaedic specialist near you by using our Physician Locator. Your personal or family doctor can also give you a referral.

If I decide to have joint replacement, what will I need to do before the surgery?

You may need routine blood tests, urinalysis, a physical examination, and you may need, if you're over 50 or your doctor thinks they're advisable, an electrocardiogram (EKG) and chest X-ray as well. Your own doctor or the hospital where you'll have the surgery may perform these preoperative tests and evaluations. You may also be asked to donate blood preoperatively or to have a designated donor — usually a family member or relative — do this. Your doctor or orthopaedic surgeon will specify exactly which tests and evaluations you will need and when you should have them. He or she may also recommend that you take an iron supplement before your surgery, and you may be asked to stop taking certain medications — for example, aspirin and other medications that thin the blood. Your doctor or orthopaedic surgeon will also specify how these and any other medication concerns apply to you. Finally, your doctor may advise you not to eat or drink after midnight on the day your surgery takes place.

What will I need to know about postoperative recovery in the hospital?

Following joint replacement surgery, hospital stays vary depending on insurance coverage and individual medical status; a total of 4 days (including the day of the surgery) is typical. The standard surgery may take from 2 to 3 hours; you may spend about the same amount of time in the recovery room. On the first day after your surgery, you will likely get out of bed and begin physical and occupational therapy, typically several brief sessions a day — first steps on your way to getting back into your life! Usually a case manager is assigned to work with you as you move through your rehabilitation routines. When you're ready for discharge, the decision will be made concerning whether you can best continue to recover at home (the usual procedure) or in another facility where you may receive specialized rehabilitation help. If you do go to another facility, the goal will be to return you to your home, able to move about with a safe level of independence, within 3 to 5 days.

What can I expect in the first days after I'm discharged?

You shouldn't be surprised if you feel a little shaky and uncertain for the first day or two after you're discharged. But soon you may get a routine going and gain confidence in your new joint — the start of a new life with less pain. (As with any surgery, you'll probably take pain medication for a few days while you are healing.) Be aware that you'll probably need a walker and/or crutches for about 6 weeks, then use a cane for another 6 weeks or so. You'll be in touch with your doctor or orthopaedic surgeon as well as your case manager, so you'll have plenty of opportunities to ask questions or discuss concerns as well as to report your progress.

When will I be able to go back to a normal daily routine, such as going to work or driving a car?

This is a decision that only you and your doctor or orthopaedic surgeon can make. However, there are some general guidelines that your doctor may give you:

Individual results may vary.