Total Knee Replacement Surgery: What You Need to Know

Total knee replacement surgery is a common surgical procedure for individuals suffering from severe knee arthritis or injury. This surgery involves resurfacing the damaged knee joint with an artificial implant to relieve pain and restore function. This comprehensive guide will help you understand total knee replacement surgery, including pre-surgery preparation, what to expect on the day of surgery, and post-surgery recovery.

About the Author: Joseph Tauro, MD, a Board-Certified orthopedic surgeon, is nationally recognized for his expertise in treating shoulder, sports, and degenerative joint disorders. As a professor at Rutgers Medical School and a Master Instructor for the Arthroscopy Association of North America (AANA), he leads the field in developing new techniques for minimally invasive joint replacement, arthroscopic shoulder surgery, and Augmented Reality surgical training. Patients from across the U.S. are referred to Dr. Tauro for his specialized care. Request an appointment with Dr. Tauro today to experience expert orthopedic care first-hand!


Medical illustration shows an arthrosis of the knee and total knee replacement surgery, with annotations.


Pre-Surgery Guidelines for Total Knee Replacement

What You Should Do Before Knee Replacement Surgery:

Consultation with Dr. Tauro:

  • Have a thorough discussion with Dr. Tauro about the procedure, risks, and benefits of total knee replacement surgery.
  • Dr. Tauro uses pre-operative computerized planning for almost all of the knee replacements he performs. This will involve the production of a custom guide to be used during your surgery. This greatly improves the accuracy of your surgery. You will need to go for a specialized MRI scan of your knee at least 6 weeks before your surgery to allow the use of this technology.

Medical Clearance and Preparation:

  • Obtain medical clearance from your primary care physician if required.
  • Review all medications with your doctor. You may need to stop certain medications, like blood thinners, a few days before surgery.

Physical and Home Preparation:

  • Engage in pre-surgery physical therapy or a home therapy program if recommended to strengthen the knee muscles before knee replacement surgery.
  • Arrange your home to accommodate your post-surgery needs. This might include setting up a comfortable resting area and ensuring easy access to necessities. You will  need a walker or crutches for assistance after surgery.

What You Shouldn’t Do Before Knee Replacement Surgery:

Eating and Drinking:

  • Do not eat or drink anything after midnight before your knee surgery day. This includes chewing gum, which can produce excessive saliva in your stomach.

Smoking and Alcohol:

  • Avoid smoking as it can impair healing and increase the risk of complications.
  • Do not consume alcohol at least 24 hours before knee replacement surgery.


Sideview of Asian elderly man wearing helmet is cycling a bicycle in the park. He recently recovered from a successful total knee replacement surgery.


Day of Total Knee Replacement Surgery

What to Do on the Day of Surgery:

Arrive on Time:

  • Arrive at the hospital or surgical center at the scheduled time. The hospital or surgery center will call you with that time generally the day before your knee replacement surgery.

Wear Comfortable Clothing:

  • Wear loose, comfortable clothing that is easy to remove and put on.

Bring Essentials:

  • Bring necessary documents and a list of medications.

What to Expect on the Day of Surgery:

Pre-Operative Preparation:

  • You will undergo pre-operative preparations, including vital sign checks and anesthesia administration. Anesthesia will usually include a regional block to numb the knee and spinal anesthesia.

Surgery Duration:

  • The procedure typically takes 1-2 hours, but this can vary depending on the complexity of the knee replacement surgery.

Post-Operative Recovery:

  • After surgery, you will be monitored in a recovery area until the anesthesia wears off.

Post-Operative Care and Recovery After Total Knee Replacement

Immediate Post-Op Care:

  • Almost all knee replacements are considered outpatient procedures. You may go home the same day or we may keep you overnight if your operation was done in the hospital. Regardless, we will have you out of bed and in a chair the day of surgery and walking with a walker or crutches the same day or the morning after the surgery.
  • We DO NOT send patients to inpatient rehabilitation facilities as we feel infection rates are higher and care is inconsistent. You are much better off at home in a clean, comfortable and familiar environment.
  • You will need to make sure a friend or family member is with you for the first 2 days after discharge.
  • We will make arrangements for physical therapy in your home for the first week or 2 after surgery. You will be given a prescription for outpatient therapy after your first visits with us 1 week after your surgery.

Prevention of Blood Clots:

  • Please take an 81mg “baby” aspirin twice a day for three weeks after your surgery.
  • If you are on stronger blood thinners (such as Elaquis or Xarelto) you should restart them the day after surgery. 

Pain Management:

  • Expect some pain and discomfort, which will be managed with prescribed medications. With the regional block, there is usually minimal pain initially, which can be managed with Tylenol and ibuprofen afterward. When the block wears off a few days after surgery, pain may increase and you may need stronger pain medication which we will prescribe. Make sure the hospital or surgery center has accurate information about your pharmacy.

Brace and Crutch Usage:

  •  You will likely need crutches or a walker to assist with walking after knee replacement surgery. Weight bearing is usually permitted immediately and progression to a cane and ultimately no assist will take place as soon as your comfort and stability is achieved.

Follow-Up Appointments:

  • Schedule follow-up appointments with your surgeon, 1 week post-surgery. You should pre-schedule this appointment in our office before your knee replacement surgery.


Caucasian elderly couple with sincere smile on faces enjoying outdoors cardio at green park. They both recovered from successful total knee replacement surgeries


Phases of Recovery After Total Knee Replacement Surgery:

Phase 1 (0-2 Weeks): Protection and Initial Healing

  • Use crutches or a walker as directed.
  • Engage in range-of-motion exercises as prescribed by Dr. Tauro and your physical therapist.
  • Full weight bearing is usually permitted. the knee elevated to reduce swelling.

Phase 2 (2-6 Weeks): Controlled Motion

  • Gradually increase controlled motion exercises under the guidance of your physical therapist.
  • Isometric exercises and some light strengthening will be started by your physical therapist
  • Focus on restoring the range of motion without straining the knee.

Phase 3 (6-12 Weeks): Strengthening

  • Incorporate progressive strengthening exercises for the knee and surrounding muscles.
  • Continue to avoid heavy lifting or activities that place excessive strain on the knee.

Phase 4 (3-6 Months): Functional Training

  • Progress to functional and everyday activities as tolerated.
  • Aim to return to normal activities gradually, following your therapist’s advice.

Full Recovery After Total Knee Replacement Surgery:

Time Frame:

  • Full recovery can take anywhere from 4-6 months to a year, depending on the extent of the surgery and your adherence to the rehabilitation program. Most patients can return to activities like walking and light exercise at 6-12 weeks post-op.



A young girl is gleefully dancing with her grandparents in the warmth of their living room, sharing a special moment of laughter and fun, all expressing happiness and the strong bond of family. Both grandparents have successfully recovered from total knee replacement surgeries.


Frequently Asked Questions (FAQs):

How long will I need to use crutches or a walker after knee replacement surgery?

  • Typically, you will need to use crutches, a walker or a cane for 4-6 weeks to support your knee.

When can I return to work after total knee replacement surgery?

  • This depends on your job and the extent of your surgery. Desk jobs may allow a return within a few weeks, while more physical jobs may require several months.

Will I regain full range of motion after knee replacement surgery?

  • With proper rehabilitation, most patients regain a significant range of motion, though individual results can vary.


Strengthen your Knees with Total Knee Replacement Surgery at AOSMI in New Jersey!

Total knee replacement surgery is a highly effective procedure for treating severe knee arthritis and injury. By following the pre-surgery guidelines, preparing adequately, and adhering to the post-operative care and rehabilitation phases, you can achieve a successful recovery and regain full function of your knee. Always communicate with Dr. Tauro and our team of orthopedic experts at AOSMI if you have any concerns during your recovery journey. If you are experiencing knee pain, are considering total knee replacement surgery, and would like a consultation, schedule an appointment with Dr. Tauro today!