What Is Total Knee Replacement?
Your knee is where the thighbone (femur), shinbone (tibia) and kneecap (patella) meet. Each surface is covered with smooth cartilage. In osteoarthritis, that cartilage wears away and bone can rub on bone. In a total knee replacement, the surgeon removes a thin layer of damaged bone and cartilage from the ends of the femur and tibia, and often the back of the kneecap, then fits metal and medical-grade plastic components that recreate a smooth, gliding joint.
At POPB, knee replacement is planned around you rather than a single standard approach. Options our surgeons use include:
- FASTREC, Dr. Martin's fast-recovery pathway for hip and knee replacement, which organizes preparation, anesthesia, pain control and early movement to help you get up and moving sooner.
- Personalized implants, in which the components are planned from your own imaging so they better match the shape of your knee. Dr. Martin offers personalized knee replacement.
- Robotic-assisted surgery. Dr. Kerr trained on the MAKO, ROSA and CORI robotic-assisted systems, which help the surgeon plan and position implants. Availability depends on the hospital or surgery center.
- P3 (Personalized Plus Program), Dr. Martin's optional concierge program for hip and knee patients, with longer visits, a dedicated concierge and direct email access.
Dr. Martin's own site covers FASTREC and personalized implants in more depth. This page gives you the practice-level overview.
Performed at a hospital or outpatient surgery center where our surgeons operate, with pre-op evaluation, imaging and physical therapy here in our Boynton Beach office.
Who Is a Candidate?
You may be a candidate if arthritis in your knee causes pain that limits walking, stairs, sleep or work, and if X-rays show significant joint damage. Most people try non-surgical care first, and our surgeons generally start there too: activity changes, weight management, anti-inflammatory medication when safe for you, physical therapy, bracing and injections such as cortisone or hyaluronic acid.
Surgery becomes a reasonable choice when those options no longer give you enough relief. Age alone does not decide it. Your surgeon will also look at your overall health, bone quality, other medical conditions and what you want to get back to. Some people with arthritis limited to one part of the knee may be better suited to a partial knee replacement.
What to Expect
Before surgery, you will have X-rays in our office and, when needed, other imaging. Your surgeon reviews the findings with you and plans the procedure. Many patients see our on-site physical therapists beforehand to build strength and learn exercises they will use afterward. Some patients choose iovera, a treatment that uses cold applied through small needles to temporarily block pain signals in nerves around the knee, as part of their recovery plan before knee replacement. William Ulrich, PA-C, performs iovera in our office.
The operation itself usually takes about one to two hours and is done under spinal or general anesthesia, often with a nerve block for pain control. Depending on your health and the facility, you may go home the same day or stay one or two nights. You will typically stand and take steps with help on the day of surgery or the next day.
Risks and Side Effects
Knee replacement is a common and well-studied operation, but it is still major surgery. Risks include infection, blood clots in the legs or lungs, stiffness, ongoing pain, bleeding, nerve or blood vessel injury, loosening or wear of the implant over time, and the general risks of anesthesia. Your surgeon will explain the steps taken to lower these risks, such as antibiotics, blood clot prevention and early walking.
Some people continue to have pain after a knee replacement. If that happens, our surgeons and Dr. Baskin evaluate the cause and discuss treatment options.
Recovery
Recovery varies from person to person. Many patients use a walker or cane for the first few weeks. Driving is often possible somewhere between two and six weeks, once you are off opioid pain medication and can control the car safely. Most daily activities become easier over six weeks to three months, and swelling and strength can keep improving for up to a year.
Physical therapy is central to your result. Because our therapists work in the same office and share your chart, your surgeon and therapist can adjust your plan together as you progress.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
Knee replacement for arthritis is usually covered by Medicare and most commercial PPO plans when it is medically necessary, though many plans require prior authorization. If you have an HMO or managed-care plan, your primary care physician's referral must be in our office before your visit. Co-pays, co-insurance and deductibles apply.
P3 concierge membership benefits are not covered by any insurance plan, although the medical care itself is billed to Medicare or your insurer as usual. Call our office and our staff will verify your benefits.
When to Talk to a Specialist
Schedule an evaluation if knee pain keeps you from walking comfortably, wakes you at night or has not improved with several months of non-surgical treatment. After surgery, go to the emergency room or call 911 if you have fever, spreading redness or drainage from the incision. Call our office the same day about new calf pain or swelling after surgery; if you cannot reach us, go to the emergency room. Call 911 for sudden shortness of breath or chest pain.
