Sunshine Coast Orthopaedic Group

Procedure · Knee · Arthroplasty

Total knee replacement.

Resurfacing the worn ends of the thigh bone and the shin bone, and the back of the kneecap where it is needed. In this practice it is planned to your own anatomy, most often with Medacta MyKnee patient-matched instrumentation, and most often performed through a quadriceps-sparing approach.

Call (07) 5493 8038 How it is performed
Reviewed by Professor Daevyd Rodda Orthopaedic Surgeon · MBBS, Dip. Surg Anat, FRACS, FAOrthA Last reviewed: 21 August 2026
Type
Major joint arthroplasty
Anaesthetic
Spinal or general, usually with a nerve block
Hospital stay
1 to 3 nights
Walking
Day of surgery, with aids
Driving
About 4 to 6 weeks
Implant survival
About 90% at 20 years (AOANJRR)

Why it's considered

Total knee replacement is generally considered when:

  • Arthritis (most commonly osteoarthritis) has worn away the cartilage that normally cushions the knee joint
  • Pain, stiffness, or swelling are limiting everyday activities, walking, stairs, sleeping
  • Non-surgical treatments (weight management, activity modification, physiotherapy, medication, and in some cases injections) haven't provided enough relief
  • X-rays confirm significant joint damage that matches the symptoms being experienced

Most people with knee arthritis manage their symptoms for years with non-surgical care before surgery becomes the right option, and for many, that non-surgical route remains sufficient indefinitely. Surgery is considered when quality of life has been meaningfully affected and other options have been exhausted.

What happens during surgery

Anaesthesia

Professor Rodda on anaesthesia for knee replacement.

Knee replacement surgery is usually performed under a combination of spinal, general, and regional anaesthesia. This is used in combination with multimodal analgesia.

Skin incision and subvastus approach

Professor Rodda on the skin incision and the muscle-sparing subvastus approach.

A skin incision is usually made at the front of the knee. This can be in the midline or placed closer to the outside. There are advantages and disadvantages to both options. Professor Rodda typically uses the muscle-sparing subvastus approach. The aim of this approach is for less postoperative pain and a faster recovery.

Patient matched technology

Before surgery, a CT scan is used to create a 3D plan tailored to your individual anatomy. Patient-matched cutting guides are then manufactured to match that plan, allowing the bone cuts to be made precisely according to your pre-operative imaging rather than relying on generic instrumentation.

Prosthesis selection

Professor Rodda on which prosthesis he uses, and why.

Professor Rodda uses a medial-pivot knee replacement design. This implant aims to reproduce the way a natural knee moves, with the medial (inner) side of the joint acting as a stable pivot point while the lateral (outer) side moves through a greater range of motion.

Kinematic alignment

Professor Rodda on kinematic alignment, explained in detail.

The implant is positioned using kinematic alignment, which aims to match the replacement to your knee's natural pre-arthritic anatomy rather than resetting the joint to a standardised position. This is covered in more detail in the dedicated kinematic alignment article.

Types of knee replacement

Total knee replacement, the whole joint surface is resurfaced. This is the most common procedure for advanced arthritis affecting multiple compartments of the knee.

Partial (unicompartmental) knee replacement, only the damaged section of the knee is replaced, suited to arthritis confined to one compartment. This isn't appropriate for everyone and depends on the pattern of joint damage.

What to expect afterwards

Recovery from total knee replacement is a gradual process involving hospital-based recovery, a structured rehabilitation program, and a return to daily activities over subsequent weeks and months. Specific timeframes vary by individual and are covered in the recovery articles of your journey.

There are three things to expect after a knee replacement that often surprise patients but are entirely normal:

  • Your knee replacement will click from time to time. This is normal. The clicking decreases with time, but even after full recovery, minor clicking can still be noticeable.
  • Numbness on the outside of your wound. The skin nerves run from the inside to the outside of the knee, so any incision down the front of the knee will disrupt them. This leaves a patch of numbness on the outside (lateral) side of the incision. The area of numbness gets smaller with time and sometimes disappears completely, but most patients are left with some residual numbness.
  • Kneeling directly on the knee is uncomfortable for most people. Around 90% of patients find it uncomfortable to kneel directly on their knee after a replacement. This will not damage the knee, but it feels uncomfortable, which is particularly important for people whose work involves kneeling, such as carpenters. If kneeling is important to you, early desensitisation exercises can be prescribed by your physiotherapist.
Questions worth asking at your consultation

Every one of these is a fair question and none of them should be awkward to ask. Print them or bring them on your phone.

  • Am I a good candidate for total knee replacement, and what would make me a poor one?
  • What are the alternatives, including doing nothing for now?
  • How many of these do you perform in a year?
  • What does the Australian registry say about the implant you would use for someone my age?
  • What does a realistic result look like for me specifically, and what will I still not be able to do?
  • What is your plan if it does not go well?

Frequently asked questions.

How long does a knee replacement last?

Australian registry data reports that approximately 90% of knee replacements performed for osteoarthritis remain in place at 20 years. Longevity depends on age at surgery, weight, activity level and implant choice.

Am I too old for a knee replacement?

There is no upper age limit. What matters is whether you are medically fit for an anaesthetic and able to participate in rehabilitation. Knee replacement is routinely performed in people in their eighties and nineties.

How painful is a knee replacement?

More painful than a hip replacement, and honest expectation is part of managing it. Pain is worst in the first two weeks and is managed with a combination of regional block, regular simple analgesia, ice and elevation. Most people are off strong analgesia by around six weeks.

Will I be able to kneel afterwards?

Many people find kneeling uncomfortable after a knee replacement, and this is a well documented outcome rather than a sign something is wrong. Kneeling does not damage the implant. Some people kneel comfortably on a cushion, and some choose not to.

Can I run after a knee replacement?

Running is generally discouraged. It is not that the knee will fail immediately, but repetitive impact increases wear of the polyethylene bearing across the life of the implant. Walking, cycling, swimming, golf and doubles tennis are all encouraged.

When can I drive after a knee replacement?

Usually four to six weeks, and when you can perform an emergency stop without hesitation and are no longer taking strong pain medication. A left knee in an automatic car may be earlier. Check your insurer's position.

Do I need a referral?

No, not immediately. You can start with a telehealth consultation with a GP or with our nurse practitioner, who can assess you and provide the referral. A referral is still needed to claim the Medicare rebate on your consultation with Professor Rodda.

References.

  1. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. Adelaide: AOA.
  2. Evans JT, Walker RW, Evans JP, et al. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):655-663.
  3. Bourne RB, Chesworth BM, Davis AM, et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57-63.

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.