The most common — and most successful — joint replacement performed today.
What is total knee replacement?
In a total knee replacement, the damaged cartilage and a thin layer of bone on the ends of the thighbone and shinbone are removed and resurfaced with metal and medical-grade plastic implants. The kneecap surface is often resurfaced as well. The goal is straightforward: a smooth-gliding joint that relieves the bone-on-bone pain of arthritis.
It is the most frequently performed joint replacement in the United States, with a long track record — and decades of data showing that the vast majority of patients experience major, lasting pain relief.
Who is a candidate?
Total knee replacement is for arthritis that affects the joint broadly — not confined to one compartment (if the damage is limited to one area, a partial knee replacement may be an option instead). Typical candidates have tried non-surgical care — exercise, weight management, medications, injections — and still find their life limited by pain, stiffness, or loss of function: trouble with stairs, walking distance, sleep, or the activities that matter to them.
Imaging confirms the extent of the arthritis, and Dr. Sloan also assesses your alignment and ligament condition to plan the operation. The decision is always based on your knee and your life, not on a single X-ray finding.
What are the options within total knee replacement?
Alignment philosophy. Surgeons have long debated how to position the implants — the traditional “mechanical” approach aims for a standardized straight-leg alignment, while newer “kinematic” or personalized approaches try to reproduce each patient’s natural anatomy. The honest state of the evidence is that no single philosophy has proven itself superior for every patient. Dr. Sloan plans alignment individually, based on your anatomy.
Robotic assistance. The Stryker Mako system can be used to plan and execute the operation with a high degree of precision — Dr. Sloan has performed over 2,000 robotic-assisted procedures.
What to expect
- Before surgery: Imaging, medical clearance, and pre-operative education so you know exactly what the day and the weeks after will look like.
- Day of surgery: Around 80% of Dr. Sloan’s primary joint replacement patients go home the same day. You’ll be up and walking with assistance within hours of the procedure.
- Recovery: Most patients progress from a walker to a cane to walking unaided over the first few weeks, guided by physical therapy. Swelling and stiffness are normal early on — improvement is measured in weeks, not days. Full recovery, where the knee starts to feel like yours, typically takes several months.
What are the risks?
Knee replacement is one of the most successful operations in medicine — but every operation carries risk, and you deserve a straight account:
- Infection — uncommon (well under 1–2% in most practices), but serious when it occurs; prevention starts before you enter the operating room.
- Blood clots — the legs are at risk after any major lower-extremity surgery; preventive measures are routine.
- Stiffness — some knees are slow to regain motion; early, consistent rehab is the best prevention, and most stiffness improves with work.
- Implant loosening or wear over time — modern implants are designed to last decades, but no implant lasts forever; younger, more active patients should discuss longevity openly.
- Persistent pain — a minority of patients have ongoing pain despite a technically well-done operation; this is an active area of research and honest discussion.
None of this should frighten you away from an operation that transforms lives daily — but an informed decision is a better one.
Frequently asked questions
How long does a knee replacement last?
Modern knee implants are designed to last decades — many last 20 years or more. Longevity depends on your activity level, weight, implant type, and surgical technique. Younger patients should have an open conversation about what a future revision might involve.
Will I be able to kneel?
Many patients can, though kneeling often feels strange or uncomfortable on the artificial joint — the sensation is odd rather than dangerous for most. Your physical therapist can work with you on it if kneeling matters for your work, worship, or hobbies.
When can I drive and return to work?
It depends on which knee was replaced, your transmission type, and how physically demanding your job is — most patients with a right knee replacement and an automatic car are cleared around 4–6 weeks, and desk workers often return sooner than those in manual labor.
Will I set off metal detectors?
Probably, yes. Implants commonly trigger airport and building security scanners. It’s a minor inconvenience — allow a little extra time, and know that security staff see this every day.
Will the knee ever feel normal?
Most patients get very close. The sharp arthritic pain is gone, and the joint moves smoothly — but many people remain aware of the knee in certain positions, especially kneeling or deep bending. The realistic goal is a knee you rarely think about, not one you never notice.
Related podcast episodes
- Episode #39 — What Happens in the First Month After Knee Replacement?
- Episode #48 — What is Knee Replacement Recovery Really Like? (Diana Braun)
- Episode #10 — What are the Most Common Knee Replacement Complications?
- Episode #35 — Is Kinematic Alignment Better? (Stephen Howell, MD)
- Episode #30 — Is Opioid-Free Joint Replacement Recovery Possible? (Andrew Wickline, MD)
Schedule a Consultation
Considering knee replacement? Meet with Dr. Sloan for an evaluation.
Schedule an Appointment · or call 978-369-5391.