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Massage therapy · Kitchener–WaterlooKnee Replacement

Knee

What It Is

If your knee is badly damaged by injury or arthritis, it might be difficult for you to perform some of the simplest activities, such as climbing stairs or walking. You might even begin feeling pain when lying down or sitting. If non-surgical treatments are no longer helping, you may want to consider knee replacement surgery. This is a safe and effective procedure to relieve pain, correct leg deformity and help you get back to normal activities (American Academy of Orthopaedic Surgeons, n.d.).

The procedure was first performed in 1968, and since then new techniques and materials have greatly increased its effectiveness. Total knee replacement is one of the most successful procedures in all of medicine. More than 700,000 total knee replacements are performed each year in the US (American Academy of Orthopaedic Surgeons, n.d.).

But How Do You Know If You Need a Knee Replacement?

The decision is made together with your doctor and an orthopaedic surgeon. People who benefit from a knee replacement often have:

  • Severe knee pain or stiffness that limits everyday activities, such as walking, climbing stairs and getting in and out of chairs.
  • Moderate or severe knee pain while resting, either day or night.
  • Long-lasting swelling in the knee that does not improve with rest or medicines.
  • A knee that bows in or out.
  • No real improvement with other treatments.

(American Academy of Orthopaedic Surgeons, n.d.)

Before you have a knee replacement, you should have tried other treatments first. These may include losing weight if you are overweight, low-impact exercise such as swimming, walking or cycling, and muscle-strengthening exercises, with support from a physiotherapist or other therapist. Often therapy is enough to relieve symptoms, and exercises can help to mobilise the stiff joint. Walking aids can also help (NHS, 2026a). I can help with these exercises, hands-on work for a stiff, sore knee, and setting up a walking aid. Your doctor may also have offered pain relief medicines, gels or creams, or a steroid injection into the knee (NHS, 2026a). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) If these treatments have not helped and your symptoms are seriously affecting your quality of life, your doctor may talk to you about a knee replacement (NHS, 2026a; National Institute for Health and Care Excellence, 2022).

Knee Replacement Anatomy

The knee is one of the biggest and most complex of all joints found in the body. It joins the shin bone and the thigh bone together. The kneecap (patella) is the third bone of the knee joint. The fibula, the thinner bone running alongside the tibia, sits just below the outer side of the knee but is not part of the knee joint itself. Tendons keep the leg muscles and knee bones connected to enable the knee joint to move. Ligaments join all of the knee bones and deliver stability to the knee.

The anterior cruciate ligament is the one that prevents the femur from sliding backward along the tibia. The medial and lateral collateral ligaments make sure the femur doesn't slide from one side to the other. It is the posterior cruciate ligament that prevents the femur from sliding forward along the tibia.

Knee replacement is usually needed when the cartilage that covers the ends of the bones has worn away (American Academy of Orthopaedic Surgeons, n.d.). The meniscus is the cushion that sits between the thigh bone and shin bone as a shock absorber. It's prone to wear and tearing.

Undergoing a Knee Replacement

The operation is done under a general anaesthetic (you are asleep) or a spinal anaesthetic (you are numb from the waist down) (NHS, 2026b). A knee replacement is sometimes called "resurfacing" because only the surfaces of the bones are replaced. There are four basic steps (American Academy of Orthopaedic Surgeons, n.d.):

1. Preparing the Bone

The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of the bone underneath.

2. Positioning the Metal Implants

The removed cartilage and bone are replaced with metal parts that recreate the surface of the joint. These metal parts may be cemented or "press-fit" into the bone.

3. Resurfacing the Patella

The underneath surface of the kneecap is cut and resurfaced with a plastic button. Some surgeons don't resurface the kneecap; it depends on your individual case.

4. Inserting a Spacer

A medical-grade plastic spacer is inserted between the metal parts to create a smooth gliding surface.

If only one side of the knee is damaged, a partial (half) knee replacement may be done instead (NHS, 2026b).

After the Operation

Once your surgeon has cleared you, I can support the exercises your hospital team and physiotherapist give you, with hands-on work for swelling, stiffness and scar tissue, and exercise to rebuild the strength and movement in your knee. See the My Approach tab for how I work.

Your knee will be sore and swollen after surgery, and it may take several months or longer to recover fully (NHS, 2026c). Your hospital team and physiotherapist will give you instructions and exercises; following them early on helps the long-term strength and movement in your knee (NHS, 2026c). Occasionally scarring inside the knee makes it stiff and limits how far it bends; this normally gets better with physical therapy and range-of-motion exercises. An average of about 115 degrees of bend is generally expected after a knee replacement, so the knee may not bend as fully as a healthy knee (American Academy of Orthopaedic Surgeons, n.d.).

Warning signs after a knee replacement

  • Signs that a blood clot may have travelled to your lungs – sudden shortness of breath, sudden chest pain, or chest pain in one particular spot when you cough: call 911 or go to the emergency room at your nearest hospital.
  • Signs of a possible blood clot in the leg – increasing pain in your calf, tenderness or redness above or below your knee, or new or increasing swelling in your calf, ankle and foot: contact your surgical team or doctor straight away.
  • Signs of a possible infection – a fever that won't go away (above 38°C or 100°F), chills, increasing redness, tenderness or swelling of the wound, fluid draining from the wound, or increasing knee pain both when active and at rest: contact your surgical team or doctor straight away.

(American Academy of Orthopaedic Surgeons, n.d.)

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

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