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Patient Education Center · Knee

Choosing Knee Replacement

Deciding to have knee replacement surgery is a big decision. My goal is never to convince someone to have surgery. My goal is to help you understand your options so you can make the decision that's right for you.

These are the same conversations I have every day in clinic with patients considering knee replacement.

Table of Contents
Do I Need Robotic Surgery?
Short AnswerNot necessarily. The most important factor in a successful knee replacement is an experienced surgeon. Robotic technology is a tool that helps your surgeon perform the operation with greater precision and consistency — it does not replace the surgeon.

One of the biggest misconceptions I hear is that the robot performs the surgery.

It doesn't.

Your surgeon performs every important part of the operation. The robot never decides what operation to perform. It never operates independently. It never replaces surgical judgment.

Instead, robotic technology provides information that helps the surgeon perform the operation more accurately.

Before surgery, a CT scan creates a three-dimensional model of your knee. During surgery, the robot helps accurately position the implants, evaluate alignment, and assess ligament balance before any bone is permanently removed.

Research consistently shows robotic surgery improves the accuracy and consistency of implant positioning. Whether that ultimately translates into longer implant survival or better long-term function is still being studied.

I use robotic technology because I believe greater precision and consistency are worthwhile advantages. At the same time, an excellent knee replacement can absolutely be performed without a robot by a skilled, experienced surgeon.

The technology is important. The surgeon is more important.

Bone Doc Tip

Technology doesn't replace experience — it enhances it.

Partial or Total Knee Replacement?
Short AnswerIt depends on where your arthritis is located. A partial knee replacement resurfaces only the damaged portion of the knee. A total knee replacement resurfaces all three compartments of the knee.

Many patients assume a partial knee replacement is always better because it is a smaller operation.

In reality, it is only better if you are the right candidate.

A partial knee replacement works best when arthritis is confined to one compartment of the knee and the remaining cartilage and ligaments are healthy.

A total knee replacement becomes the better option when arthritis affects multiple compartments or when the knee has significant deformity or instability.

Choosing the wrong operation can lead to persistent pain or the need for another surgery. That is why careful evaluation of your X-rays, physical examination, and overall knee function is so important.

The best operation is not necessarily the smaller one. It is the operation that best matches your arthritis.

Bone Doc Tip

The best operation isn't the smallest one — it's the right one.

Why Do You Call It a Resurfacing Instead of a Replacement?
Short AnswerBecause that's what it actually is. We are not replacing your entire knee. We are resurfacing the worn-out joint surfaces.

"Knee replacement" is the common term, but it can create unrealistic expectations. Many patients imagine the entire knee is removed and replaced with an artificial joint.

That isn't what happens.

The ligaments that stabilize your knee are largely preserved. The muscles remain your own. Most of the bone remains your own.

Only a few millimeters of damaged cartilage and bone are removed from the joint surfaces. Those worn surfaces are then covered with precisely fitted metal components. A smooth plastic spacer acts as the new cartilage between them.

That is why I often tell patients to think of it as resurfacing a road. You are removing the potholes and laying down a new smooth surface — not rebuilding the entire highway.

This also helps explain why a knee replacement never feels exactly like the knee you had at age eighteen. It is still your knee. It has simply been resurfaced.

Bone Doc Tip

A knee replacement is really a knee resurfacing.

How Long Does a Knee Replacement Last?
Short AnswerMost modern knee replacements last fifteen to twenty years or longer, and many last the rest of a patient's lifetime.

Today's implants are extremely durable.

Multiple long-term studies have shown that over ninety percent of modern knee replacements are still functioning well fifteen to twenty years after surgery. Many continue to function much longer.

How long an implant lasts depends on several factors:

  • Implant positioning
  • Surgical technique
  • Body weight
  • Activity level
  • Overall health
  • Chance

Normal activities like walking, hiking, golf, swimming, cycling, and doubles pickleball are encouraged. High-impact repetitive activities may increase wear over time.

The goal is one operation that serves you well for decades.

Bone Doc Tip

Most patients only need one knee replacement in their lifetime.

What Happens During Surgery?
Short AnswerDuring surgery, the damaged joint surfaces are carefully resurfaced with metal and plastic implants designed to restore smooth movement.

Most knee replacements take approximately one to two hours.

After the knee is exposed, the damaged cartilage and a small amount of underlying bone are removed. The knee is then balanced so the ligaments provide stability throughout motion.

Metal implants are secured to the femur and tibia. A durable plastic spacer is placed between them to create a new low-friction bearing surface. If appropriate, the back of the kneecap may also be resurfaced.

Once stability, alignment, and motion have been confirmed, the incision is closed.

Most patients begin walking the same day.

Bone Doc Tip

The operation is only the beginning. Your recovery is just as important as the surgery itself.

What Are the Risks?
Short AnswerKnee replacement is one of the most successful operations in medicine, but every surgery carries risks.

Fortunately, serious complications are uncommon.

Potential risks include:

  • Infection
  • Blood clots
  • Stiffness
  • Bleeding
  • Nerve or blood vessel injury
  • Fracture
  • Persistent pain
  • Implant loosening over time
  • Need for future revision surgery
  • Medical complications related to anesthesia

Most patients recover without major complications. Before surgery we carefully review your medical history and optimize any conditions that may increase your risk.

The purpose of discussing risks is not to create fear. It is to help you make an informed decision.

Bone Doc Tip

Every operation has risks — but living with severe arthritis has costs too.

Can Both Knees Be Replaced at the Same Time?
Short AnswerSometimes. Whether both knees can be replaced during one operation depends on your health, goals, and the severity of arthritis.

For selected healthy patients, replacing both knees during the same surgery can reduce the number of hospitalizations and recovery periods.

However, it also places greater stress on the body and may increase certain risks.

For many patients, staging the surgeries several months apart is the safer option.

This decision is individualized after discussing your health, support system, and recovery goals.

Bone Doc Tip

One operation isn't always better than two. The safest plan is the best plan.

Will My New Knee Feel Normal?
Short AnswerProbably not exactly — but it should feel much better.

One of the most important expectations to understand is that a knee replacement is designed to reduce pain and improve function. It does not recreate the knee you had as a teenager.

Many patients tell me they eventually "forget about" their knee during daily activities. Others remain aware that it is an artificial joint, especially when kneeling or during weather changes.

Success is measured by your ability to return to the activities you enjoy with far less pain — not by making the knee feel exactly natural.

Bone Doc Tip

The goal isn't to make your knee eighteen again. The goal is to get you back to living your life.

Still Have Questions?

Every knee is different. If knee pain is limiting your life, schedule an appointment to discuss your symptoms and treatment options with Dr. Jadye Kee.

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