Frequently asked questions about knee replacement
Below are answers to some of the most frequently asked questions about knee replacement. But these FAQs are not a substitute for medical advice from your doctor. Please be sure to speak with your doctor about any questions regarding your specific symptoms, diagnosis and treatment options.
What can I expect the day of surgery?
Every hospital has its own procedures. While you should discuss any specific procedures they may have in place, you may expect to follow this basic routine. Arrive at the hospital at your appointment time and complete the registration and admission process. Your care team will assess your vital signs (like blood pressure and temperature) and your general health. You’ll change into a hospital gown and likely settle into a pre-surgery room. Your anesthesiologist and operating room nurse will come in to talk with you, and the team will start the IV (intravenous) line that will be used to administer fluids and medication. Your family can usually stay with you until the team wheels to the operating room where your orthopaedic surgeon and your surgical team will perform your knee replacement. After the surgery, you’ll be wheeled into a recovery room where your recovery team will monitor your vital signs until you’re ready for transport to your hospital room. From there, the hospital floor nursing team will continue to monitor your vital signs and your incision site and dressing. You may be surprised how quickly you’ll be evaluated by a physical therapist. The team will get you moving with special post-op activities. You’ll also begin a diet of clear liquids or soft foods as soon as you can tolerate it.
What kinds of tests will I need before surgery?
Your doctor wants to make sure you’re healthy and prepared for surgery and recovery. You’ll likely need a physical checkup, routine blood work, and a urine test. If you’re over 50, or have a heart or respiratory issue, you may also need an EKG and a chest X-ray. Your doctor will recommend specific tests based on your specific diagnosis and medical condition.
What type of anesthesia will I have?
Spinal anesthesia is the preferred method for most total knee replacement surgeries. Ask your anesthesiologist about the method recommended for you and any other concerns you have.
Am I too old for a knee replacement?
While age is an important factor in your health, age alone is usually not a reason to not have knee replacement surgery. Your doctor will be more interested in your overall health, and will consider a variety of things such as blood test results, your physical strength, bone density, diet/lifestyle, etc. to determine whether knee replacement is right for you.
Will I need a blood transfusion during my surgery?
Not everyone needs blood during knee replacement surgery.1 If necessary, the hospital provides blood that has been screened in compliance with universal guidelines that help ensure patient safety. In some cases, autologous blood donations, in which a patient donates their own blood to potentially be used during their surgery, can be coordinated. If done, the blood donation must be done several weeks prior to the date of surgery. Speak to your doctor about your options.
1. Carling MS, Jeppsson A, Eriksson BI, Brisby H. Transfusions and blood loss in total hip and knee arthroplasty: A prospective observational study. J Orthop Surg Res, 2015;10:48. ((URL: https://josr-online.biomedcentral.com/articles/10.1186/s13018-015-0188-6))
What should I bring to the hospital?
Wear comfortable, loose-fitting clothing. Most hospitals supply basic toiletries, non-skid socks, and a gown. You’ll want to bring an overnight bag with a few personal toiletries, like shaving supplies, a robe, and anything that will make you feel more comfortable. (Avoid bringing valuables.) And, be sure to bring a list of your current medications and any paperwork the hospital requested. If you use, or plan to use your own assistive device for walking – cane, crutches, or walker – have someone bring it to the hospital before you’re discharged (no need to bring it now).
How early should I arrive at the hospital on the day of my surgery?
Generally, hospitals request that you arrive two hours before your scheduled surgery time. This gives you plenty of time for the admission process, to change into your hospital gown, and to meet the anesthesiologist and nursing team who will be with you during your surgery. It also gives you time to ask questions and settle in. Talk to your hospital to see their recommended arrival time.
It is typically important for patients not to eat or drink after midnight the night before surgery. But you should ask your doctor for instructions about when to stop eating or drinking. Sometimes your physician may allow you to take some of your critical daily medication the morning of surgery. If this is the case, take the medication with the least amount of water necessary. Be sure to tell the admitting nurse if you’ve taken medication.
Should I attend the knee replacement class offered by the hospital?
Your case manager, who assists you before, during, and after your surgery, will schedule you to attend a pre-operative class so you and your family members learn more about what to expect and how to support you. These highly recommended classes usually rotate weekly between total knee replacement and total hip replacement. By attending class, you and your case manager will be better equipped to plan for your surgery and recovery experience. Contact the hospital for further details about the pre-operative class.
Am I too old for a knee replacement?
While age is an important factor in your health, age alone is usually not a reason to not have knee replacement surgery. Your doctor will be more interested in your overall health, and will consider a variety of things such as blood test results, your physical strength, bone density, diet/lifestyle, etc. to determine whether knee replacement is right for you.
What are the major risks of knee replacement surgery?
As with any surgery, knee replacement surgery has serious risks which include, but are not limited to, pain, infection, bone fracture, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.
Implant related risks which may lead to a revision include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal and/or foreign body sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), and reaction to particle debris. Knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.
How long do knee implants last?
The lifetime of a knee replacement is not infinite and varies with each individual. However, with normal wear, knee replacements can potentially last for many years.1 At the 16-year mark, only 8% of knee replacements required a revision, with implant loosening being the main reason.2 The lifetime of any knee replacement depends on several factors like weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. Talk with your doctor about the implant best suited for you.
1. AAOS website. OrthoInfo:Total Knee Replacement. https://orthoinfo.aaos.org/en/treatment/total-knee-replacement/ Accessed 22 February 2019.
2. Australian Orthopaedic Association. National Joint Replacement Registry, Hip, Knee and Shoulder Arthroplasty. Annual Report 2017. Pg 196.
What can I expect the day of surgery?
Every hospital has its own procedures. While you should discuss any specific procedures they may have in place, you may expect to follow this basic routine. Arrive at the hospital at your appointment time and complete the registration and admission process. Your care team will assess your vital signs (like blood pressure and temperature) and your general health. You’ll change into a hospital gown and likely settle into a pre-surgery room. Your anesthesiologist and operating room nurse will come in to talk with you, and the team will start the IV (intravenous) line that will be used to administer fluids and medication. Your family can usually stay with you until the team wheels to the operating room where your orthopaedic surgeon and your surgical team will perform your knee replacement. After the surgery, you’ll be wheeled into a recovery room where your recovery team will monitor your vital signs until you’re ready for transport to your hospital room. From there, the hospital floor nursing team will continue to monitor your vital signs and your incision site and dressing. You may be surprised how quickly you’ll be evaluated by a physical therapist. The team will get you moving with special post-op activities. You’ll also begin a diet of clear liquids or soft foods as soon as you can tolerate it.
What kinds of tests will I need before surgery?
Your doctor wants to make sure you’re healthy and prepared for surgery and recovery. You’ll likely need a physical checkup, routine blood work, and a urine test. If you’re over 50, or have a heart or respiratory issue, you may also need an EKG and a chest X-ray. Your doctor will recommend specific tests based on your specific diagnosis and medical condition.
Will I need a blood transfusion during my surgery?
Not everyone needs blood during knee replacement surgery.1 If necessary, the hospital provides blood that has been screened in compliance with universal guidelines that help ensure patient safety. In some cases, autologous blood donations, in which a patient donates their own blood to potentially be used during their surgery, can be coordinated. If done, the blood donation must be done several weeks prior to the date of surgery. Speak to your doctor about your options.
1. Carling MS, Jeppsson A, Eriksson BI, Brisby H. Transfusions and blood loss in total hip and knee arthroplasty: A prospective observational study. J Orthop Surg Res, 2015;10:48. ((URL: https://josr-online.biomedcentral.com/articles/10.1186/s13018-015-0188-6))
How long will I be in the hospital?
Most people spend one to four days in the hospital.1 Depending on your particular surgery and recovery, your team will help decide what’s best for you. Some people go right home. Some go to a rehab center. Some go to a “sub-acute” care center that is a step between the hospital and a rehab center. Talk with your insurance company about the options that are covered by your plan and recommended for you. Typically, your case manager, who assists you before, during, and after your surgery, will help you coordinate your recovery care.
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
What should I bring to the hospital?
Wear comfortable, loose-fitting clothing. Most hospitals supply basic toiletries, non-skid socks, and a gown. You’ll want to bring an overnight bag with a few personal toiletries, like shaving supplies, a robe, and anything that will make you feel more comfortable. (Avoid bringing valuables.) And, be sure to bring a list of your current medications and any paperwork the hospital requested. If you use, or plan to use your own assistive device for walking – cane, crutches, or walker – have someone bring it to the hospital before you’re discharged (no need to bring it now).
How early should I arrive at the hospital on the day of my surgery?
Generally, hospitals request that you arrive two hours before your scheduled surgery time. This gives you plenty of time for the admission process, to change into your hospital gown, and to meet the anesthesiologist and nursing team who will be with you during your surgery. It also gives you time to ask questions and settle in. Talk to your hospital to see their recommended arrival time.
It is typically important for patients not to eat or drink after midnight the night before surgery. But you should ask your doctor for instructions about when to stop eating or drinking. Sometimes your physician may allow you to take some of your critical daily medication the morning of surgery. If this is the case, take the medication with the least amount of water necessary. Be sure to tell the admitting nurse if you’ve taken medication.
After surgery, will the surgeon talk to my family about how my surgery went?
Typically, your doctor or one of the assisting surgeons will come out to the waiting area to talk with your family as soon as you’ve been taken into the recovery room. If your family misses seeing the surgeon, they should contact the surgeon’s office. Your doctor’s office will arrange a time for your surgeon to discuss your surgery with your family.
When will I be discharged from the hospital?
It depends on you, your recovery process, and your doctor’s recommendation. Most people go home within one to four days after surgery.1
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
What type of anesthesia will I have?
Spinal anesthesia is the preferred method for most total knee replacement surgeries. Ask your anesthesiologist about the method recommended for you and any other concerns you have.
How long is the surgery?
Every patient is different and individual surgery times will vary. In general, most patients expect to spend two to three hours in surgery and another two to three hours in the recovery room.
After surgery, how soon can I get back to daily activities?
Most people who undergo knee replacement surgery and participate in a physical therapy regimen prescribed by their doctor, return to their day-to-day activities like driving in four to six weeks,1 but everyone is different. Your doctor will help determine a plan best suited for your recovery and your lifestyle.
Reference: 1. Marecek GS, Schafer MF. Driving after orthopaedic surgery. J Am Acad Orthop Surg. 2013;21(11):696-706.
How long will I be in the hospital?
Most people spend one to four days in the hospital.1 Depending on your particular surgery and recovery, your team will help decide what’s best for you. Some people go right home. Some go to a rehab center. Some go to a “sub-acute” care center that is a step between the hospital and a rehab center. Talk with your insurance company about the options that are covered by your plan and recommended for you. Typically, your case manager, who assists you before, during, and after your surgery, will help you coordinate your recovery care.
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
Should I go home or to a rehab facility after leaving the hospital?
It’s recommended that someone assist you full time for the first 48-72 hours after discharge. After that you’ll still need assistance part time for a minimum of one to two weeks. Your case manager will make arrangements for continued physical therapy either at home or at an outpatient facility. If you live alone or may need extra assistance getting out of bed or standing from a chair (or if you home has lots of stairs and no bathroom on the first floor, for example), your case manager may recommend that you spend a few days in a rehab facility. Talk with your case manager to decide the best plan for you.
When can I walk up and down stairs?
Although everyone is different, you may practice walking up and down stairs in physical therapy before you leave the hospital.1 If your doctor allows, you can climb stairs once or twice a day at home during your recovery.
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
Will I have pain after I leave the hospital?
Most people who’ve had knee replacement need a short course of medication to manage their pain. You may only need the medication at night or before physical therapy. Talk with your doctor about what to expect.
Will I need a walker or crutches?
You’ll likely use a walker or crutches for about six weeks after surgery to help you walk safely and in good form. After that, most patients graduate to using a cane for the next six weeks or so. From then on out, most people who’ve had knee replacements walk well without any support.
Will the surgeon speak to my family right after the surgery?
Typically, your doctor or one of the assisting surgeons will come out to the waiting area to talk with your family as soon as you’ve been taken into the recovery room. If the family misses seeing the surgeon, they should contact the office. Your doctor’s office will arrange a time for your surgeon to discuss your surgery with your family.
What happens the days after surgery while I’m in the hospital?
You’ll be wheeled from the recovery area to your hospital room on the orthopaedic surgery floor a few hours after surgery. You may still have an IV for fluids and pain medication. The first night following surgery you may feel groggy from anesthesia and pain medication, but once you’re fully awake, you may be able to eat and drink if allowed by your doctor. Your care team will monitor your vital signs, urinary output, and drainage from the incision site. Your leg may be placed on a continuous passive motion (CPM) machine that gently bends and straightens your leg without exertion. You may be surprised that your care team will begin getting you out of bed on the first day after surgery. You’ll likely have both physical and occupational therapy to get you moving safely and feel more confident when you move. The physical therapist focuses on weight-bearing techniques when using a walker or crutches, and teaching you exercises that encourage recovery. The occupational therapist will help you manage your day-to-day routine, like dressing, bathing, using the bathroom, and getting in and out of chairs, while you’re recovering.
Will I see my doctor after the surgery while I’m in the hospital?
Doctors make rounds daily to see their patients whenever possible. Twice a day, the orthopaedic residents or physician assistants will likely monitor your progress and make any changes to your care schedule to ensure you’re comfortable. In addition to your doctor and a resident or physician assistant, your case manager will meet with you (and family members, if necessary) in order to ensure the most appropriate discharge plan for you. That may mean making arrangements for transfer to a rehabilitation floor or sub-acute floor at the hospital or at another facility.
Should I go home or to a rehab facility after leaving the hospital?
It’s recommended that someone assist you full time for the first 48-72 hours after discharge. After that you’ll still need assistance part time for a minimum of one to two weeks. Your case manager will make arrangements for continued physical therapy either at home or at an outpatient facility. If you live alone or may need extra assistance getting out of bed or standing from a chair (or if you home has lots of stairs and no bathroom on the first floor, for example), your case manager may recommend that you spend a few days in a rehab facility. Talk with your case manager to decide the best plan for you.
When will I be discharged from the hospital?
It depends on you, your recovery process, and your doctor’s recommendation. Most people go home within one to four days after surgery.1
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
What should I expect the first days after discharge from the hospital?
You may feel overwhelmed for a couple of days. After all, you just had surgery. But once you settle in at home and get a feel for your new knee, you’ll likely begin to feel that you’re turning a corner for the better. If you don’t, and you feel your pain or discomfort is getting worse – or have any concerns at all – call your doctor. Your case manager will check up on you in a minimum of one to two days to ask you a few questions and see how you’re doing. If you have questions or concerns, tell your case manager.
Do I need someone to stay with me around the clock when I get home?
It's recommended that someone assist you full time for the first 48-72 hours after discharge. After that you’ll still need assistance part time for a minimum of one to two weeks. If you live alone and friends or family members ask to help, consider taking them up on the offer. The extra support will give you greater peace of mind. Talk with your case manager to decide the best plan for you.
How long do knee implants last?
The lifetime of a knee replacement is not infinite and varies with each individual. However, with normal wear, knee replacements can potentially last for many years.1 At the 16-year mark, only 8% of knee replacements required a revision, with implant loosening being the main reason.2 The lifetime of any knee replacement depends on several factors like weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. Talk with your doctor about the implant best suited for you.
1. AAOS website. OrthoInfo:Total Knee Replacement. https://orthoinfo.aaos.org/en/treatment/total-knee-replacement/ Accessed 22 February 2019.
2. Australian Orthopaedic Association. National Joint Replacement Registry, Hip, Knee and Shoulder Arthroplasty. Annual Report 2017. Pg 196.
After surgery, how soon can I get back to daily activities?
Most people who undergo knee replacement surgery and participate in a physical therapy regimen prescribed by their doctor, return to their day-to-day activities like driving in four to six weeks,1 but everyone is different. Your doctor will help determine a plan best suited for your recovery and your lifestyle.
1. Marecek GS, Schafer MF. Driving after orthopaedic surgery. J Am Acad Orthop Surg. 2013;21(11):696-706.
Will I need a walker or crutches?
You’ll likely use a walker or crutches for about six weeks after surgery to help you walk safely and in good form. After that, most patients graduate to using a cane for the next six weeks or so. From then on out, most folks who’ve had knee replacements walk well without any support.
When can I go out?
You may feel like getting outdoors, but talk with your doctor first. Let your safety and comfort be your guide. With someone else driving you, start with short trips, like to outpatient physical therapy appointments or the local supermarket. Increase the length of time you spend outdoors, and the number of trips you take, as you feel more comfortable.
When can I drive?
Most people who’ve had a knee replacement are not allowed to drive for six weeks. Depending on which knee was replaced and how you’re recuperating, your doctor may have other recommendations. Consult your physician.
When can I return to work?
Everyone’s different, but most people don’t return to work until after their six-week post-op checkup. Talk with your doctor for recommendations based on your job duties, your surgery, and your recovery.
When can I get back to sports?
In a few weeks your doctor may allow you to pick back up with lower-impact activities like hiking, walking, cycling, and golfing.
What should I expect the first days after discharge from the hospital?
You may feel overwhelmed for a couple of days. After all, you just had surgery. But once you settle in at home and get a feel for your new knee, you’ll likely begin to feel that you’re turning a corner for the better. If you don’t, and you feel your pain or discomfort is getting worse – or have any concerns at all – call your doctor. Your case manager will check up on you in a minimum of one to two days to ask you a few questions and see how you’re doing. If you have questions or concerns, tell your case manager.
Do I need someone to stay with me around the clock when I get home?
It's recommended that someone assist you full time for the first 48-72 hours after discharge. After that you’ll still need assistance part time for a minimum of one to two weeks. If you live alone and friends or family members ask to help, consider taking them up on the offer. The extra support will give you greater peace of mind. Talk with your case manager to decide the best plan for you.
When can I walk up and down stairs?
Although everyone is different, you may practice walking up and down stairs in physical therapy before you leave the hospital.1 If your doctor allows, you can climb stairs once or twice a day at home during your recovery.
1. American Academy of Orthopaedic Surgeons. Activities After Knee Replacement. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/activities-after-knee-replacement/ Accessed 25 February 2019.
Will I have pain after I leave the hospital?
Most people who’ve had knee replacement need a short course of medication to manage their pain. You may only need the medication at night or before physical therapy. Talk with your doctor about what to expect.
Important information
Knee Replacements
Total knee replacement is intended for use in individuals with joint disease resulting from degenerative, rheumatoid and post-traumatic arthritis, and for moderate deformity of the knee.
Knee replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the knee, or excessive body weight.
As with any surgery, knee replacement surgery has serious risks which include, but are not limited to, pain, infection, bone fracture, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.
Implant related risks which may lead to a revision include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal and/or foreign body sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), and reaction to particle debris. Knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.
The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is right for you. Individual results vary and not all patients will return to the same postoperative activity level. The lifetime of any joint replacement is limited and varies with each individual. Your doctor will counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device. Such strategies include not engaging in high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your doctor’s instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if the joint replacement is right for you.
Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Mako, Mobile Bearing Hip, Stryker, Together with our customers, we are driven to make healthcare better. All other trademarks are trademarks of their respective owners or holders.
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