In short
If your knee pain no longer responds to medication and physiotherapy, replacement surgery may be on the table. Here is what the operation actually involves, from the first consultation to walking unaided.
Total knee replacement, also called total knee arthroplasty, replaces the worn surfaces of a damaged knee joint with an implant made of metal and high-grade plastic. It is one of the most reliable operations in orthopaedics, but it is also major surgery — and it is worth understanding properly before you agree to it.
Who actually needs a knee replacement?
Knee replacement is considered when arthritis has worn the cartilage to the point that bone rubs against bone, and when that damage is causing pain and stiffness that non-surgical treatment can no longer control. The decision is based on how much your daily life is restricted, not only on what an X-ray shows.
Typical signs that surgery is being considered seriously:
- Pain that wakes you at night or is present at rest, not only on walking
- Difficulty climbing stairs, getting off a chair or walking more than a short distance
- Deformity — the leg bowing inward or outward as the joint collapses on one side
- Little or no relief from painkillers, weight management, physiotherapy or injections
What happens during the operation
The surgeon removes the damaged surface of the thigh bone and shin bone, along with the worn cartilage, and caps them with implant components. A plastic spacer sits between them to act as the new smooth surface. The kneecap may also be resurfaced depending on its condition.
The operation usually takes one to two hours. Most knee replacements in India are performed under spinal anaesthesia, which numbs you from the waist down and avoids the grogginess of general anaesthesia. Many patients also receive a nerve block for pain relief in the first day.
Recovery: the honest version
You will usually be helped to stand and take a few steps within 24 hours. Walking with a support is expected for the first two to four weeks. Most people manage stairs by around three to four weeks and walk without support somewhere between four and eight weeks — though this range is wide and depends heavily on your muscle strength before surgery.
Full recovery, meaning the point where the knee stops feeling like a new joint you are conscious of, typically takes three to six months. Swelling that comes and goes for several months is normal and not a sign that something has gone wrong.
What decides how well you do
- 1Physiotherapy. This is the single biggest factor within your control. Knees stiffen quickly, and a knee that is not moved early is far harder to rehabilitate later.
- 2Strength before surgery. Patients who arrive with stronger thigh muscles recover faster. Pre-operative physiotherapy is worth the effort.
- 3Weight. Every extra kilogram is multiplied several times through the knee when you walk, which affects both comfort and implant life.
- 4Managing other conditions. Well-controlled blood sugar in particular reduces the risk of wound problems and infection.
Risks you should hear about
Knee replacement is a well-established operation with generally good outcomes, but no surgery is risk-free. The risks worth discussing with your surgeon include infection, blood clots in the leg, stiffness, ongoing pain in a small number of patients, and eventual loosening or wear of the implant many years later. A surgeon who explains these clearly is doing their job properly.
Questions worth asking your surgeon
- Is my arthritis affecting one compartment or the whole knee? Would a partial replacement be an option?
- What implant are you using, and why that one for me?
- Will you use robotic assistance, and what difference does it make in my case?
- What range of movement should I realistically expect, including floor-sitting?
- How many of these do you perform, and what does your rehabilitation programme look like?
If you are weighing up knee replacement, a consultation should end with you understanding your options — including the option of waiting. Our orthopaedic team in Basaveshwar Nagar, Bengaluru assesses each knee individually and will tell you plainly if surgery is not yet warranted.
Frequently asked questions
How long does a knee replacement last?+
Modern implants commonly last 15 to 20 years or more, and outcomes depend on your age, weight, activity level and how well the implant is aligned. Younger and heavier patients place more load on the implant, which can shorten its life.
Will I be able to sit cross-legged or squat afterwards?+
Many patients regain a deep bend, but this varies with implant type, your pre-surgery stiffness and your rehabilitation. Discuss floor-sitting and squatting with your surgeon before surgery, as it matters a great deal in Indian households and can influence the surgical plan.
Is knee replacement painful?+
The operation itself is done under spinal or general anaesthesia, so you feel nothing during it. Afterwards, pain is managed with a planned combination of medication and often a nerve block. Most patients are helped to stand within a day of surgery.
This article is general health information, not medical advice, and it cannot account for your individual circumstances. Please consult a qualified orthopaedic specialist about your own symptoms before making treatment decisions.
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