Step into comfort: Understanding knee replacement surgery
[6 MIN READ]
In this article:
- The knee is one of the body’s most active and complex joints.
- When arthritis or injury damages the knee joint, replacement surgery may be an option to restore comfort and movement.
- Two Providence Swedish orthopedic surgeons explain what you should know before surgery, how the procedure works and why adhering to rehabilitation protocol is important to your recovery.
How your knees keep you moving
Every stride, step and stretch starts with your knees. They power movement, absorb impact and help you stay steady through it all. Inside, the joint works like a hinge that connects the thigh bone (femur) to the shin bone (tibia). The femur has a rounded end, while the tibia is flat. This design allows for smooth motion, but it also relies on several supporting parts to stay stable:
- Cartilage: A smooth surface that lets the bones glide easily
- Ligaments: Tough bands of tissue that stabilize the joint
- Meniscus: A soft, rubbery cushion that absorbs shock from movement
“The knee is a bit of a miracle structure,” says David Belfie, M.D., an orthopedic surgeon at Providence Swedish Orthopedics. “It takes a beating and serves its purposes beautifully, but it relies on several moving parts working in balance. When one fails, the knee starts to hurt.”
Dr. Belfie works closely with Cameron Egan, M.D., a fellow orthopedic surgeon at Providence Swedish Orthopedics. Together, they share insights into what causes knee joint damage and how replacement surgery can make movement easier again.
What causes knee pain?
Because the knee relies on many parts working together, it’s prone to wear and tear. Over time, or after an injury, the smooth cartilage that protects the bones begins to break down.
Arthritis is the most common cause of this breakdown. In osteoarthritis, years of movement gradually thin and damage cartilage until the bones start to rub together. Rheumatoid arthritis and other inflammatory conditions can also affect the joint lining, causing similar symptoms.
“The pain, swelling and stiffness you feel come from that bone-to-bone contact,” Dr. Egan explains. “When cartilage thins out, the joint becomes inflamed and sore. That’s when we start thinking about replacement.”
Exploring non-surgical options first
But before recommending surgery, Dr. Belife and Dr. Egan take a careful look at all possible treatment options.
“There’s no problem that surgery can’t make worse,” says Dr. Belfie, noting that procedures are never risk-free. “So even though we’re surgeons, we always make sure patients have tried every reasonable alternative first.”
Those options may include:
- Activity modifications and supportive braces
- Injections or oral medications for pain relief
- Physical therapy and exercise to strengthen muscles
- Weight management to reduce stress on the joint
For many people, these steps can reduce pain and improve movement enough to delay or avoid surgery altogether.
When knee replacement is the right choice
If pain persists despite other treatments, knee replacement may be the next step. Your surgeon will tailor the procedure to your anatomy and the amount of joint damage.
“There are three compartments in the knee — inside (medial), outside (lateral) and under the kneecap (patellofemoral),” explains Dr. Egan. “If arthritis affects only one area, a partial knee replacement may be enough. But if two or more are involved, we typically perform a total knee replacement.”
Some surgeons use robotic tools to precisely guide bone cuts, though outcomes are similar with both robotic and traditional techniques.
“My suggestion is to choose a surgeon who’s experienced and comfortable with their approach,” advises Dr. Egan.
What happens during knee replacement surgery?
Knee replacement is a well-established, safe and effective surgery to restore the joint surfaces. During the procedure, your surgeon will make a small incision at the front of your knee to access the joint. They’ll remove the damaged areas, then cap the ends of the bones with smooth metal and plastic components. These new surfaces mimic your knee’s natural motion, so it can bend and move freely again.
“Most people are surprised to learn that knee replacement surgery is often an outpatient procedure,” says Dr. Egan. “We usually perform it under spinal anesthesia, and the whole thing takes about one to two hours. Patients can go home the same day and begin walking with a walker right away.”
Although complications are rare, Dr. Egan emphasizes that every procedure carries some risk. The most common concerns are blood clots and infection, but surgeons take steps to prevent them through early movement and medication.
The road to recovery
Rehabilitation is where much of the progress happens. Your care team will create a personalized recovery plan to gradually rebuild your strength and mobility. Sticking with that plan — even when it’s challenging — plays a major role in your long-term success.
“Knee replacement is one of the most successful surgeries we do in medicine. Success rates are 90–95%,” says Dr. Egan. “But that number heavily depends on patient participation. Good surgery and good rehab go hand in hand.”
Here’s what your recovery may look like:
- Weeks 1 – 2: Focus on controlling swelling and pain with gentle range-of-motion exercises
- Weeks 2 – 4: Continue physical therapy to build strength and flexibility
- Months 1 – 3: Transition from walker or cane to walking independently
- Months 3 – 6: Reach about 90% of your total improvement, though full recovery can take up to a year
Dr. Belfie also emphasizes the importance of planning ahead. Having someone at home to help and working with a trusted therapist can make a big difference in how you feel after surgery.
Modern advances in knee replacement care
Today’s implants are built for comfort and longevity, lasting 15 to 20 years or longer. Ongoing advances in design and materials have improved durability and help the joint move and feel more like a natural knee.
While knee replacement surgery works well for both men and women, there are a few subtle differences in knee shape and anatomy. Women tend to have smaller, narrower knees and slightly different bone angles. Dr. Egan explains that advanced imaging and surgical planning tools now allow surgeons to customize alignment and implant selection, ensuring a comfortable fit for everyone.
Get the most out of your new knee
At Providence Swedish Orthopedic Institute, patients benefit from a steady, team-based approach — from pre-surgery education to same-day discharge and follow-up calls.
“We deliver seamless care from start to finish, so patients experience fewer complications and higher satisfaction with their new knee,” says Dr. Belfie.
Learn more and find a physician or advanced practice clinician (APC)
If knee pain is slowing you down, the Swedish Orthopedic Institute can help. Our experienced surgeons offer the latest options in knee replacements and non-surgical care so you can restore comfort, mobility and confidence in every step.
Find an Orthopedic Institute location to schedule an appointment. You can also schedule a virtual consultation through Swedish ExpressCare Virtual. Use our directory to connect with an orthopedic surgeon or primary care physician near you.
Related resources
Get the facts on joint replacement
Find ways to relieve the discomfort of painful joints
Keep moving! Maintain mobility as you age
Knee replacement surgery — when is it time to say yes?
What you “kneed” to know about caring for your joints
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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