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Knee Replacement Protocol

Knee replacement surgery — also known as knee arthroplasty (ARTH-row-plas-tee). The procedure involves cutting away damaged bone and cartilage from your thighbone, shinbone and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade plastics and polymers.

In determining whether a knee replacement is right for you, an orthopedic surgeon assesses your knee's range of motion, stability and strength. X-rays help determine the extent of damage.

Your doctor can choose from a variety of knee replacement prostheses and surgical techniques, considering your age, weight, activity level, knee size and shape, and overall health.

Why it's done

The goal is to help relieve pain and restore function in severely diseased knee joints. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have knee pain at rest.


Knee replacement surgery carries risks. Risks are common for any type of surgery. They include:

  • Infection
  • Blood clots in the leg vein or lungs
  • Nerve damage
  • Heart attack
  • Stroke

Before surgery

You might be advised to stop taking certain medications and dietary supplements before your surgery. You'll likely be instructed not to eat anything after midnight the day of your surgery.


Prepare for your recovery

For several weeks after the procedure, you will most likely need to use crutches or a walker, so arrange for them before your surgery. Make sure you have a ride home from the hospital and help with everyday tasks, such as cooking, bathing and doing laundry. If you live alone, you may discharge from the surgery center to a rehabilitation center to help build daily living tasks.

To make your home safer and easier to navigate during recovery, consider doing the following:

  • Create a living space on one floor since climbing stairs can be difficult.
  • Install safety bars or a secure handrail in your shower or bath.
  • Secure stairway handrails.
  • Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
  • Arrange for a toilet-seat riser with arms if you have a low toilet.
  • Get a stable bench or chair for your shower.
  • Remove loose rugs and cords.

Signs of infection

Notify your doctor immediately if you notice:

  • Fever greater than 101.5 F
  • Shaking chills
  • Drainage from the surgical site
  • Increased tenderness and pain in the knee

What to expect post operatively

A prescription will be given to you to help manage pain after surgery. These prescriptions do expire. Please pick it up and keep it in a safe place.

SWELLING AND BRUISING IS EXPECTED. You may use ice at the site. Elevate extremity and use compression stocking.

Your dress will be removed at your two week post op appointment.

You may shower with surgical bandage on as it is waterproof.


Schedule a Post-operative follow up at 2 weeks and 6 weeks

Continue Physical Therapy exercises as directed. You may do PT at home or at an outpatient facility.

Please take Aspirin 81 mg twice a day to prevent blood clots.


Three to six weeks after surgery, you generally can resume most daily activities, such as shopping and light housekeeping. Driving is also possible at around three weeks if you can bend your knee far enough to sit in a car, if you have enough muscle control to operate the brakes and accelerator, and if you're not still taking narcotic pain medications.

After recovery, you can engage in various low-impact activities, such as walking, swimming, golfing or biking. But you should avoid higher impact activities — such as jogging, skiing, tennis and sports that involve contact or jumping. Talk to your doctor about your limitations.

  • Maimonides Medical Center
  • Columbia University Medical Center
  • Rutgers Robert Wood Johnson Medical School