Quick Answer: Total knee replacement is a surgical procedure that removes damaged cartilage and bone from the knee joint and replaces them with metal and plastic implants. Most patients return to walking within days and resume normal activities within three to six months.
Knee arthritis affects millions of Americans, and for many, there comes a point where medication, injections, and physical therapy no longer provide enough relief. Total knee replacement, also called total knee arthroplasty, is one of the most successful elective surgeries in modern medicine. The AAOS reports that more than 790,000 total knee replacements are performed in the United States each year, with that number expected to grow significantly as the population ages. If you or someone you know in the Inland Empire or Southern California is approaching this decision, here is a clear, honest guide to what the process involves.
What Happens Inside the Knee?
The knee is a hinge joint where the femur (thighbone), tibia (shinbone), and patella (kneecap) meet. Articular cartilage covers the ends of these bones and allows smooth movement. When arthritis destroys that cartilage, the bones begin to rub against each other, causing pain, swelling, and loss of function. Bone spurs can develop, and the knee may lose its natural alignment.
Total knee replacement does not actually replace the entire knee joint. It resurfaces the ends of the bones and the underside of the kneecap with metal and plastic components, restoring the smooth gliding surface that cartilage once provided.
Are You a Candidate?
Your orthopedic surgeon will evaluate you for knee replacement based on several factors:
- Persistent knee pain that limits daily activities such as walking, climbing stairs, or getting in and out of a chair
- Pain that continues at rest or wakes you at night
- Moderate to severe osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis confirmed on X-ray
- Failure to find lasting relief from non-surgical treatments including anti-inflammatory medications, corticosteroid injections, and physical therapy
Age, weight, and overall health are also factors. The procedure is most common in patients between 60 and 80 years old, though it is sometimes performed in younger patients with severe joint damage. Patients across the Pomona Valley and San Gabriel Valley often ask us whether they are too young or too old for this surgery. The honest answer is that the decision is based on quality of life and joint condition, not age alone.
What to Expect: The Procedure Step by Step
Before Surgery
Preparation begins weeks before your operation. You will have a full physical examination, blood work, and imaging to plan the procedure. Your care team will review your medications, as some blood thinners and anti-inflammatory drugs need to be paused. Pre-surgical physical therapy, sometimes called prehab, can strengthen the muscles around the knee and improve post-operative recovery.
The Day of Surgery
Total knee replacement is typically performed under regional anesthesia (a spinal or epidural block) or general anesthesia. The surgeon makes an incision over the front of the knee, moves the kneecap aside, and removes the damaged bone and cartilage from the end of the femur and the top of the tibia. Metal implants are then cemented or press-fit into place, and a plastic spacer is positioned between them to recreate smooth joint movement. If the underside of the kneecap is worn, it may be resurfaced as well. The procedure typically takes 60 to 90 minutes.
Immediately After Surgery
Recovery begins within hours. Most patients are up and walking with assistance on the same day or the morning after surgery. Physical therapy starts immediately, focusing on range of motion and strength. A pain management plan using a combination of local nerve blocks, non-opioid medications, and ice therapy helps keep discomfort manageable.
Recovery Timeline: What to Expect Week by Week
One of the most common questions we hear from patients across the Claremont and Inland Empire area is: how long does recovery actually take? Here is a realistic breakdown.
- Week 1 to 2: Walking with a walker or crutches. Swelling is significant. Daily physical therapy focuses on bending and straightening the knee.
- Weeks 2 to 6: Transitioning from a walker to a cane. Stair climbing begins. Most patients are doing light household activities independently.
- Weeks 6 to 12: Many patients drive again and return to desk work or light jobs. Swelling continues to decrease. Range of motion improves steadily.
- 3 to 6 months: Most patients resume normal activities including light recreational exercise. The knee continues to feel more natural over this period.
- 12 months: Full recovery with maximum improvement in strength and function. Many patients report complete resolution of pre-surgical pain.
According to research published in the Journal of Bone and Joint Surgery, more than 90 percent of total knee replacements are still functioning well 15 years after surgery.
Risks and Realistic Expectations
No surgery is without risk. For total knee replacement, the main risks include blood clots, infection, stiffness, and implant-related issues such as loosening over many years. Your surgical team will take specific precautions to minimize each of these, including blood thinners to prevent clots and antibiotic prophylaxis to guard against infection.
It is also worth being realistic about pain levels. The knee may feel warm, stiff, and uncomfortable for several months after surgery. Some patients feel a clicking sensation or light numbness around the incision, which is normal. Most people describe a steady, gradual improvement rather than a dramatic overnight change.
If you're experiencing knee pain that is limiting your daily life, the team at Garey Orthopedic Medical Group is here to help. We offer same-day and next-day appointments for new patients. Visit gareyortho.com or call us to schedule today.