Preparing for knee replacement

Overview

A knee replacement is a surgery to replace a damaged knee joint with an artificial one made of metal and plastic. It's done to relieve severe pain and improve movement when other treatments haven't helped.

Yes, knee replacement is very common. Thousands of people have the surgery each year, and the number is growing as people live longer and stay active.

It mostly affects people over 50, especially those with advanced knee arthritis. It can also affect younger people if the knee is severely damaged by injury or disease.

Symptoms

Common symptoms

• Constant knee pain, even when resting or at night
• Stiffness, especially in the morning or after sitting
• Swelling and tenderness around the knee
• Difficulty walking, climbing stairs, or getting up from a chair
• A feeling that the knee is unstable or giving way

Symptoms in children

• Knee replacement in children is very rare. Children with severe knee problems might have other types of surgery instead.

Symptoms in older adults

• Same symptoms as adults, but older adults may also have weaker muscles that make walking harder.
• Older adults may be more prone to falls because of knee pain and instability.

Causes

Main causes

• Osteoarthritis – the most common cause, where the cushioning cartilage wears away over time.
• Rheumatoid arthritis – an autoimmune condition that causes joint inflammation and damage.
• Post-traumatic arthritis – damage from a previous knee injury, like a fracture or torn ligament.

Risk factors

• Age – risk increases after 50.
• Weight – extra weight puts more stress on the knee joint.
• Family history of arthritis or knee problems.
• Previous knee injury or surgery.
• Jobs or sports that involve repeated knee stress.

When to see a doctor

See a doctor urgently if:

• If your knee suddenly becomes hot, red, and very painful – this could be an infection or gout.
• If you cannot put any weight on your knee after a fall or injury.

Book a routine appointment if:

• If knee pain is regular and limits your daily activities, such as walking, climbing stairs, or sleeping.
• If over-the-counter pain relievers, ice, and rest no longer help.
• If your knee feels unstable or locks up.

Diagnosis

Your doctor will ask about your symptoms, examine your knee, and check how well you can move it. They will also review your medical history and may order imaging tests.

Tests that may be done

• X-rays to see the amount of cartilage loss and bone changes.
• MRI scan if more details are needed, especially for soft tissue injuries.
• Blood tests to rule out infections or other types of arthritis (like rheumatoid).

What to expect at your appointment

If you are considering knee replacement, your doctor will discuss the risks, benefits, and what to expect. You may see a specialist (orthopedic surgeon) who will explain the surgery and preparation steps.

Treatment

Before knee replacement, doctors recommend trying non-surgical treatments first. If they don't provide enough relief, surgery can help. Preparation includes getting your body and home ready for recovery.

Self-care at home

• Lose weight if your doctor advises it – this reduces stress on the knee.
• Strengthen the muscles around your knee with exercises like leg raises and gentle walking – ask a physiotherapist for a plan.
• Quit smoking – smoking slows healing and increases risks.
• Practice using crutches or a walker before surgery.

Medical treatments

Doctors may prescribe pain relievers, anti-inflammatory medications, or steroid injections to reduce pain and swelling before surgery. They might also recommend physical therapy to improve strength and range of motion. Always take medications exactly as prescribed and tell your doctor about any other medicines or supplements you take.

When is surgery considered?

Surgery is usually considered when pain and joint damage are severe, and non-surgical treatments no longer control symptoms. Your surgeon will decide the best timing based on your overall health and readiness.

Living with this condition

After knee replacement, most people need several weeks of recovery. You'll use a walker or crutches at first. Physical therapy is key to regain movement and strength. By 3 months, many people can walk without aids. Full recovery can take up to a year.

Lifestyle tips

• Keep your home safe – remove loose rugs, have a firm chair with armrests, and keep essentials within easy reach.
• Plan for help – you may need assistance with meals, bathing, and errands for the first few weeks.
• Stay active – gentle walking and prescribed exercises will help your new knee work well.

Diet and exercise

Eat a balanced diet rich in protein, vitamins, and minerals to help healing. Include calcium and vitamin D for bone health (dairy, green leafy vegetables, fortified foods). Avoid too much salt and sugar. Do the exercises your physiotherapist gives you – they are designed to restore movement and strength safely.

Mental health and emotional wellbeing

Recovery can be emotionally challenging. It's normal to feel frustrated, down, or anxious. Talk to friends, family, or a counsellor. If you have thoughts of harming yourself, contact a crisis line or your local emergency number immediately. You are not alone.

Prevention

You can't always prevent the need for knee replacement, but you can reduce your risk of severe knee arthritis. Keeping a healthy weight, staying active, and avoiding knee injuries are important steps.

Complications

If left untreated

• Severe knee arthritis can lead to permanent loss of movement and inability to walk.
• Chronic pain can affect sleep, mood, and overall quality of life.
• Weakness in the leg can increase the risk of falls and fractures.

Long-term outlook

For most people, knee replacement dramatically reduces pain and improves mobility. It allows them to enjoy daily activities again. While recovery takes time and effort, the results are usually very good.

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