Total Knee Replacement Surgery

Overview: Knee Replacement Pathway and Decisions

Total knee replacement (TKR) can free you of pain and change your life. But, it involves numerous decisions and challenges. It is important to prepare and plan for each stage before and after surgery.  Watch this video to get an overview of the knee replacement pathway, from considering surgery to living with an artificial knee.  View Transcript

Knee Replacement Pathway and Decisions



Today over 600,000 knee replacement surgeries take place every year in the U.S.  For many, this surgery is the ticket to a more active life, letting them put the daily struggle with severe knee pain behind.  While it is most certainly a life changing event, knee replacement is a big decision that is not without challenges and risks.  During each stage, before and after surgery, patients face questions, tasks and considerations for which they will want to be physically and psychologically prepared.  From considering surgery to living with an artificial knee, taking the time to get informed will enable you to navigate the process comfortably and with confidence. 


Dr. Thomas Vail, Professor and Chairman of Orthopedic Surgery, University of San Francisco (UCSF) Medical Center:

"The average age of a patient having a knee replacement in the United States is sixty-eight years of age and that really hasn't changed much in the past decade.  Knee problems are very common, and that's something that people should be aware of, and there are a variety of treatments for ailments of the knee."


Dr. Thomas Coon, Orthopedic Surgeon | Coon Joint Replacement Institute, St. Helena Hospital:

"When it becomes a substantially limiting factor in your life, when you can't go to the grandkids ballgame, when you can't climb the bleachers, then it's time to think about having something done to treat your knee pain."



While the majority of patients undergo a total knee replacement, some are candidates for partial knee replacement. Regardless of what procedure is right for you, it is important that you find an orthopedic surgeon who is well trained and has plenty of experience with knee replacement. 

Dr. Thomas Coon:

"In preparation for knee replacement it's advisable to be in as good a shape physically as you can.  Many of our patients have multiple health issues.  You need to try to keep your flexibility and muscle tone so that you can have a rapid recovery after the surgery.  Your surgeon or hospital may have a preoperative education program that occurs before you have your total knee replacement."



Once you have carefully chosen a surgeon and prepared for the costs you might incur, it's important to educate yourself about what to expect during the operation, recovery and rehabilitation periods.  If possible talk to others who have had the surgery and ask questions about what to expect.  Recovery and rehabilitation can be painful and challenging and will require hard work and dedication. 


Jamie Nelson, Physical Therapist, UCSF Medical Center:

"We really work on function in the very beginning.  Squats, which is just a small sit-to-stand; straight-leg-raises; knee extensions, where you're just bending your knee in the air; standing on one leg.  You know, balance activity, because you've got to be able to balance on one leg in order to walk normally."


Dr. Thomas Vail:

"For most patients it takes about three months to get back to feeling like yourself.  They may feel a little bit like lacking in confidence for a while, while they are recovering from knee surgery, and that's what takes three months to really regain so that you're moving around without thinking about the knee."



Eighty percent of artificial knee joints last twenty years, it's important to maintain a healthy lifestyle, including keeping your weight down and engaging in the appropriate exercise.   


Dr. Thomas Coon:

"One of the most rewarding and gratifying things for me is to take patients who are unable to walk or are barely able to walk, perform a fairly short operation, have them up walking the same day and then seeing them walk out of the hospital."


Jamie Nelson:

"It's an adjustment period for the first six months, but you'll find that without pain you're doing a lot better and you're a lot happier person.  It's a very successful surgery."


Dr. Thomas Vail:

"I always stress to patients, the more they know, the more they can learn about knee replacement and the expectations after surgery; the more successful the operation will be."



Knee replacement surgery has the power to change your life.  Proper planning can reduce problems and stress and will help ensure that you make good decisions and receive the best care.  There are many details involved in preparing for, undergoing, recovering from, and living with the procedure.  An understanding of the actions you can take at each stage of the process will help you obtain a healthy and pain-free life. 

Meaningful Insights at Any Stage

More than 90 percent of patients experience dramatic pain relief and improvement in knee function after a total knee replacement (TKR). Determining whether to have surgery is only the first step. Use this guide to understand the decisions and considerations you will face at each stage before and after surgery. Get the big picture»

Considering Knee Replacement?

The decision to undergo surgery requires serious consideration. Whether you’re researching treatment options or your doctor has recommended surgery, it’s important to weigh the risks and benefits.

Preparing for Surgery

By planning ahead and learning what to expect before, during, and after your surgery, you can help ensure a smooth and successful recovery.

Recovery and Rehabilitation

Most people resume and enjoy a more active life within 12 weeks after surgery. Committing to a rehab program will help speed your recovery and reap the benefits of your new knee.

Living with an Artificial Knee

Knee implants can last longer than twenty years, and for most they are the ticket to a more active lifestyle. Learn how to maximize the performance of your artificial knee.


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