Regional (spinal or epidural) anesthesia numbs you below your waist. You will also receive medicines to make you relax or feel sleepy.
The surgeon will make a cut over your knee. This cut is about 3 to 5 inches long.
Next, the doctor examines the entire knee joint. If there is damage to more than one part of your knee, you may need a total knee replacement. Most of the time, however, this is not needed since the tests you had before the procedure would have shown this damage.
The damaged bone and tissue is removed.
A man-made part made of plastic and metal is placed into the knee.
Once the part is in the proper place, it is attached with bone cement.
The wound is closed with stitches.
Why the Procedure Is Performed
The most common reason to have a knee joint replaced is to relieve severe arthritis pain.
Your doctor may recommend knee joint replacement if:
You can’t sleep through the night because of knee pain.
Your knee pain prevents you from doing daily activities.
Your knee pain has not gotten better with other treatments.
Ask your doctor which medicines you can still take on the day of your surgery.
You may be asked to stop taking medicine that makes it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin) and other drugs.
You may need to stop taking any medicines that weaken your immune system, including Enbrel and methotrexate.
If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.
Tell your doctor if you have been drinking a lot of alcohol (more than one or two drinks a day).
If you smoke, you need to stop. Ask your doctor or nurse for help. Smoking slows healing and recovery.
Let your doctor know if you get a cold, flu, fever, herpes breakout, or other illness before your surgery.
You may want to visit a physical therapist before surgery to learn exercises that can help you recover.
Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87(5):999-1006.
Patil S, Colwell CW Jr, Ezzet KA, et al. Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am. 2005;87(2):332-338.
Richmond J, Hunter D, Irrgang J, et al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad Orthop Surg. 2009;17:591-600.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.