Once the first year is behind you, the questions change from how to recover to how to live with it. These are the ones asked most.
Sport and activity.
Encouraged, within limits that are about the bearing surface rather than about safety.
Encouraged: walking, cycling, swimming, golf, doubles tennis, bowls, hiking on reasonable ground, gym work, dancing.
Generally discouraged: running, jumping sports, singles tennis, competitive court sports, and heavy repetitive impact.
The reasoning is worth understanding rather than just accepting. The knee will not fail the first time you run on it. Repetitive impact increases wear of the polyethylene bearing, and wear particles are the main driver of loosening over decades. You are trading long-term implant survival against short-term activity, and for most people the trade is not worth it.
Skiing, horse riding and similar carry a fall risk with a fracture around the implant as the consequence. That is a personal decision, discussed individually.
Kneeling.
Many people find kneeling uncomfortable after a knee replacement, and this is one of the most consistently reported findings. It does not damage the implant. The discomfort is usually from the scar and the soft tissue at the front rather than from the implant itself.
Practical suggestions: use a cushion or a gardening pad, kneel on the non-operated side where possible, and try again periodically, because it often improves into the second year. If your work requires sustained kneeling, raise it before surgery so it can be factored in.
Dental work and antibiotics.
Guidance has changed and many patients are still working from older advice. Current Australian and international guidance does not recommend routine antibiotic prophylaxis before dental procedures for most patients with joint replacements. The evidence that it prevents joint infection is weak, and antibiotics carry their own risks.
Some patients with specific risk factors, such as significant immunosuppression or a previous joint infection, may still be advised to have them. That is an individual decision made with your surgeon and dentist.
What does matter is treating dental infection when it occurs, promptly. Untreated infection anywhere in the body can seed a joint replacement.
Flying and airport security.
There is no restriction on flying with a knee replacement once you have recovered, but avoid long-haul flights in the first six weeks because of clot risk. On any long flight, walk the aisle periodically, stay hydrated and consider compression stockings.
On security: implant cards are no longer generally issued or accepted as proof and are not needed. Modern implants sometimes set off walk-through detectors and sometimes do not. Tell the screening officer you have a knee replacement and follow their process.
How long it lasts.
Australian registry data reports that approximately 90 percent of knee replacements performed for osteoarthritis are still in place at twenty years. Longevity depends on age at surgery, weight, activity level and implant choice.
The practical implication is about age. A replacement at 75 will very likely outlast you. A replacement at 55 has a meaningfully higher chance of needing a revision at some point.
Long-term follow-up.
You will be reviewed at twelve months and then periodically. Long-term surveillance matters because some loosening and wear is silent: it produces changes on a radiograph before it produces symptoms, and catching it early means a smaller operation if revision is eventually needed.
Every joint replacement performed in Australia is recorded in the national registry, which is how the survival figures on this site exist at all.
When to get it checked.
- New pain in a knee that had settled.
- A change in how it feels, sounds or moves.
- Swelling that returns after having resolved.
- Any infection elsewhere in the body with new joint pain.
- A fall with immediate pain or inability to weight bear.
Common questions.
Can I run after a knee replacement?
Running is generally discouraged. The knee will not fail immediately, but repetitive impact increases wear of the polyethylene bearing over the life of the implant. Walking, cycling, swimming, golf and doubles tennis are all encouraged.
Do I need antibiotics before dental work?
Current Australian and international guidance does not recommend routine antibiotic prophylaxis for most patients with joint replacements. Some patients with specific risk factors may still be advised to have them. What matters more is treating dental infection promptly when it occurs.
Will I set off airport security?
Sometimes. Modern implants may or may not trigger walk-through detectors. Implant cards are no longer generally issued or accepted as proof and are not needed. Tell the officer you have a knee replacement and follow their process.
How long before I can fly?
There is no restriction once you have recovered, but avoid long-haul flights in the first six weeks because of clot risk. On long flights, move regularly, stay hydrated and consider compression stockings.
How long will my knee replacement last?
Australian registry data reports about 90 percent still in place at 20 years. Longevity depends on your age at surgery, weight, activity level and implant choice. Younger and more active patients place more demand on the bearing.
Do I need check-ups if it feels fine?
Yes. Some loosening and wear is silent and shows on a radiograph before it causes symptoms. Periodic review means a problem is caught while the solution is still a smaller operation.
This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.