Your knee is the largest joint in your body, and it carries your full weight every time you stand, walk, or climb stairs. When arthritis or injury damages it badly enough, painkillers, physiotherapy, and injections may no longer be enough — and a surgeon may suggest a total knee replacement.
It is major surgery, with a recovery of several months. It is also one of the most successful operations in modern medicine, when it is done for the right patient, at the right time, by the right surgeon.
This guide lists the questions to ask before you agree — about the surgery itself, the risks, recovery, how long the new knee will last, and what it will cost. Use it at your consultation, and take notes on the answers.
What Is a Total Knee Replacement?
Total knee replacement, also called total knee arthroplasty (TKA), is an operation to replace the damaged surfaces of the knee joint with metal and plastic parts that move together like a normal knee.
The surgeon removes the damaged bone and cartilage from the end of the thigh bone and the top of the shin bone, and sometimes the underside of the kneecap, and fits the artificial joint in their place. The aim is to relieve pain, correct deformity, and restore movement — not to give you a brand-new, perfect knee.
It is usually recommended only when pain and stiffness are severe, daily activities are significantly limited, and non-surgical treatments have been tried and have not worked.
15 Questions to Ask Your Surgeon
1. Do I actually need a knee replacement now — or could I wait?
Ask what non-surgical options are still worth trying, and whether waiting would make the eventual result worse. There is no evidence that waiting damages the result of the eventual operation, but you will live longer with the symptoms. The timing is a balance between how much your life is limited now and the lifespan of the implant.
2. Am I a good candidate?
Age, weight, general health, bone quality, and how active you are all matter. Younger patients carry a higher lifetime risk of needing a revision, because they live longer and use the knee harder. Your surgeon should explain your individual risk, not just the average.
3. Partial or total replacement?
A partial (unicompartmental) replacement replaces only the damaged part of the knee. It is a smaller operation with a faster recovery, but it is only suitable if the rest of the knee is healthy. Ask which you need and why.
4. What will happen during surgery, and how long will it take?
The operation typically takes 1–2 hours. The surgeon makes an incision across the front of the knee (usually 6–10 inches for a traditional approach, smaller for minimally invasive techniques), moves the kneecap to one side, removes the damaged cartilage and a small amount of bone, and fits the metal and plastic parts. You will usually have a spinal or general anaesthetic, plus local anaesthetic around the joint.
5. Will you use robotic assistance — and does it matter?
Robotic-assisted surgery uses computer planning and a robotic arm to help the surgeon position the implant accurately. It does not perform the operation on its own. A 2026 network meta-analysis found robotic systems differed in their strengths, while conventional surgery was faster to perform, and a 2025 meta-analysis found no significant difference in implant survival between robotic and conventional surgery. Ask your surgeon what they use, why, and what difference they expect it to make for you — not just that it is “more advanced.”
6. What are the risks?
All surgery carries risk. For knee replacement, the recognised complications include infection (about 1–2%), blood clots (about 2–3%), stiffness (about 5–10%), nerve or blood-vessel injury, fracture, implant loosening or wear, persistent pain, and the need for revision surgery. Your surgeon has a responsibility to explain these in plain language, including the type of anaesthesia, the risk of cardiac problems or stroke, and — rarely — loss of life. About 1 in 5 patients is not fully satisfied with the result, often because of ongoing pain or stiffness, or because expectations were not matched to what surgery can achieve.
7. How long will I be in hospital?
Most people leave hospital 1–3 days after surgery, once the wound is healing well and they can move around safely. Some people go home the same day or the next day under rapid-recovery protocols; others, especially those who live alone or need more support, may need a short rehabilitation stay.
8. What will recovery look like, week by week?
NICE expects you to be up with a physiotherapist on the day of surgery or within 24 hours. Most patients can use a walker or crutches to get up and move within 24 hours, and are discharged 2–3 days later.
- Weeks 1–2: walking with a frame or crutches, physiotherapy to bend and straighten the knee, pain and swelling are at their worst — pain is often worst on day 2–3.
- Weeks 3–6: walking aids are gradually dropped; many people walk without an aid at about 6 weeks.
- Weeks 6–12: return to work is usually 6–12 weeks, depending on your job; driving is usually after at least 6 weeks, once you can do an emergency stop comfortably without strong painkillers.
- Months 3–6: most daily activities are easier; strength and endurance keep improving.
- Months 6–12: full strength and stamina can take 6–12 months.
Many people still need painkillers at six weeks, particularly to sleep, and bruising pain is normal for about two months. That is not a sign that something has gone wrong — but do tell your surgeon if pain is getting worse rather than better.
9. What should I do before surgery to get the best result?
You will usually have a pre-surgical evaluation a few days before the operation, with blood tests and checks to confirm you are fit for surgery. Your surgeon may ask you to do exercises to strengthen the muscles around the knee, lose weight if needed, stop smoking, and review your medications — especially blood thinners. Ask for a written list.
10. How long will the new knee last?
NHS guidance is that a total knee replacement can last 20 years or more. A published study reported 10-year survival of 96.4% for cemented knee replacements. But lifespan varies with age, activity, body weight, implant design, and alignment — no individual lifespan can be guaranteed. National Joint Registry data show 15-year revision rates of around 16% for people under 55, compared with under 3% for people over 75, and a lifetime revision risk of about 5% for patients over 70, rising to up to 35% for men in their early 50s. That is why timing matters, especially for younger patients.
11. What implant will you use, and why?
Ask the brand and type (cemented or uncemented), how long it has been used, and what its published survival data show. A newer implant is not automatically better — a long track record is valuable.
12. What will it cost, and what is included?
Cost varies by country, hospital, implant, and whether robotic assistance is used. Get a written quote that includes the surgeon’s fee, hospital stay, anaesthesia, implant, physiotherapy, and follow-up visits. If you are travelling for surgery — for example, to see the best knee replacement surgeon in Mohali or in any other city — ask the same questions you would at home, and check who provides follow-up care once you return.
13. Who will do my follow-up care, and what if there is a problem?
Ask who you contact after discharge, how often you will be reviewed, and what happens if you develop a fever, increasing pain, redness, swelling in the calf, or wound discharge. These can be warning signs of infection or a blood clot and need prompt attention.
14. What can I do — and not do — after surgery?
Most people can walk, swim, cycle, and play golf after recovery. High-impact activities such as running and jumping are usually discouraged, as they wear the implant faster. Kneeling does not damage a well-fixed implant, but wait until your surgeon says it is safe — usually about three months, on a soft surface. Avoid lifting, vacuuming, and changing beds for about three months, per NHS advice.
15. What if I am not happy with the result?
Ask what the plan is if pain or stiffness persists — further physiotherapy, manipulation under anaesthetic for stiffness, investigation for infection or loosening, or, rarely, revision surgery. Knowing the plan in advance makes a difficult outcome easier to handle.
The Bottom Line
Knee replacement is not a decision to rush. The operation itself takes 1–2 hours, but recovery takes months, and the implant is expected to last 20 years or more — so the surgeon, the timing, and your expectations all matter.
Go to your consultation with these questions written down, take notes, and do not agree to surgery until you understand the risks, the recovery, and what a realistic result looks like for you.
Frequently Asked Questions (FAQs)
How painful is knee replacement recovery?
It is known for a harder early recovery than hip replacement. Pain is managed with spinal or general anaesthesia, local anaesthetic around the joint, and regular painkillers. Pain is usually worst on the second or third day, and many people still need painkillers at six weeks.
When can I walk after knee replacement?
Most people are up with a physiotherapist on the day of surgery or within 24 hours, using a walker or crutches. Walking without an aid is usually possible at about six weeks.
When can I drive after knee replacement?
NHS advice is to wait at least six weeks after a total knee replacement (about three weeks after a partial), and only once you can do an emergency stop comfortably without strong painkillers.
When can I shower after knee replacement?
Usually from the second day after surgery, following your surgeon’s instructions. Steri-strips over the incision can get wet and should be gently dried afterwards; they are usually removed 10–14 days after surgery.
How long does a knee replacement last?
A total knee replacement can last 20 years or more, according to NHS guidance. Lifespan depends on age, activity, weight, and implant type — younger, more active patients have a higher lifetime chance of needing a revision.
Is robotic knee replacement better?
Robotic assistance can improve alignment accuracy, but published meta-analyses have not shown a consistent overall clinical advantage or better implant survival compared with conventional surgery. It is a surgical tool, not a guarantee of a better result.
