Questions to Ask Before Knee Replacement Surgery
For anyone sitting down with an orthopedic surgeon about a total or partial knee replacement, and for the relative going along. The questions follow the order the decision takes: whether to operate now or wait, the operation and the surgeon, the risks, the hospital and pain control, recovery and therapy, then home, driving and work.
The questions
Each question, and why to ask it
Now or wait
How worn is my knee, and which parts of the joint are affected?
Why ask it
Ask to see the X-ray and have the surgeon point to the inner side, the outer side and the area behind the kneecap. Where the wear sits has a lot to do with whether a partial replacement is on the table, so write down which parts were named.
Is the pain I have the kind a knee replacement usually takes away?
Why ask it
Describe it exactly first: at night, on stairs, after sitting, at the front or along the inside. A careful answer says which of those the operation tends to help and whether your hip or back has been ruled out as the source. 'It will all be gone' deserves a follow-up.
What haven't I tried that could put surgery off for a few years?
Why ask it
Say first what you have done and for how long, including each injection and whether it bought you weeks or months. Then ask which remaining option deserves a real trial on your knee. A flat 'nothing' should come with a reason taken from your own X-ray.
What do I lose, if anything, by waiting another six months or a year?
Why ask it
Listen for specifics, such as a leg that is bowing further, thigh muscle getting weaker or a bend that keeps shrinking. 'Not much, come back when you are ready' is a legitimate answer, and it takes the pressure off the decision.
Which of the things I've given up am I likely to get back, and which am I not?
Why ask it
Bring three in writing: the walk you used to take, the stairs at home, the sport or the garden. Mention kneeling by name, because surgeons answer it differently and it is one people are often surprised about afterward.
How will I know when it is time?
Why ask it
Many surgeons have markers they go by: pain that wakes you, how far you can walk, what you have stopped doing. Get this surgeon's, then check them honestly against your last month, not your best day.
Does my age or my weight change whether this is a good idea?
Why ask it
Better said out loud than worried about in the car home. Ask how either one changes the plan or the risks for you. If the practice has a weight or blood test cutoff for operating, find out what it is and how close you are.
Both my knees are bad. Would you do one at a time or both together?
Why ask it
Skip this if only one knee is in question. Otherwise ask which goes first, how long you would wait between them, and what doing both at once would mean for the risks and for how much help you would need at home.
The operation
Am I a candidate for a partial knee replacement, or does it have to be a total?
Why ask it
A clear answer names what rules you in or out: where the wear is, the state of the ligaments, how the leg lines up. If this surgeon does not do partials at all, that may have shaped the answer, and a second opinion from one who does both is reasonable.
If I have a partial, how likely am I to need a total later on?
Why ask it
Surgeons often describe a trade here: an easier recovery now against a greater chance of a second operation. Have this one weigh it for someone your age and as active as you are, and ask what converting a partial to a total involves.
How many knee replacements do you do in a year, and how many of those are partials?
Why ask it
Someone who does these every week can usually answer without looking anything up. If a partial is planned, the second number is the one that counts, and a low one is a reason to ask who in the practice does more.
Do you operate with a robot, computer navigation or standard instruments, and why?
Why ask it
Surgeons disagree about how much the tool changes the result, so ask about this surgeon's experience with it and not the machine's brochure. Find out how many knees they have done that way, whether it means an extra scan beforehand and whether it adds to your bill.
Who else will be in the operating room, and which parts do you do yourself?
Why ask it
At a teaching hospital a resident or fellow often assists, and an assistant may close the wound. That is ordinary. If you want the surgeon doing the main steps personally, this is the moment to say so and hear the reply.
Which implant do you plan to use, and how long have you been using it?
Why ask it
You are not expected to judge brands. What reassures is a design the surgeon has put in many times and that has years of results behind it. Some countries keep a joint registry that reports on implants, so ask whether there is one where you live.
How long should this knee last, and what would wear it out sooner?
Why ask it
Treat any number of years as an estimate from large groups of patients, never as a promise about yours. The second half is the part you can use: which activities, how much body weight and what kind of work the surgeon would steer you away from.
Will the implant be cemented, and will you resurface my kneecap?
Why ask it
Surgeons make both choices differently, and you do not have to referee the debate. Ask 'why that way for me' and listen for a reason drawn from your bone, your age or the wear behind your kneecap.
Should I be tested for a metal allergy first?
Why ask it
Worth raising only if jewelry, a watch back or a belt buckle has ever given you a rash. Opinions differ on how much it matters in a knee, so the practical question is what the surgeon would do differently if a test came back positive.
Risks
What is my risk of infection, and what do you do to lower it?
Why ask it
Concrete answers sound like a routine: antibiotics at the time of surgery, a skin wash the night before, a blood sugar check. Then ask about your part, including what to do if you get a cut on that leg, a tooth problem or a bladder infection in the week before.
What will I take to prevent blood clots, and for how many weeks?
Why ask it
It might be a pill or an injection, along with getting up and moving early. Mention any clot you or a close relative has had, hormone treatment and any long trip coming up, since each of those can change what is prescribed.
How often do your patients end up with a stiff knee, and what do you do about it?
Why ask it
Ask what counts as stiff in degrees. A surgeon with a set checkpoint, a bend they expect by a certain week, is more reassuring than one who says it rarely happens. Then ask what the next step is when the mark is missed, and whether it would mean another anesthetic.
How many people still have pain a year later, even though nothing went wrong?
Why ask it
An honest surgeon will tell you that some do, and that the cause is not always found. Notice whether you get a plain answer or a change of subject. Then ask if anything about your knee or your health makes it more likely for you.
What could go wrong during the surgery itself, such as damage to a nerve or blood vessel?
Why ask it
These are the uncommon ones, and a surgeon should be able to say so and still describe them. Ask what you or the nurses would notice afterward, a foot you cannot lift for example, and how it would be handled. Ask separately whether to expect a numb patch of skin beside the scar.
Which symptoms mean I call your office, and which mean the emergency room?
Why ask it
Have the surgeon sort these four for you: calf pain or swelling, chest pain or shortness of breath, fever, and a wound that reddens or leaks. Write down which get a phone call and which get an ambulance, and save the after-hours number in two phones, yours and your helper's.
Which of my health conditions worries you most for this operation?
Why ask it
Diabetes, heart or lung trouble, sleep apnea, kidney problems and smoking are the usual ones. The helpful reply picks one and gives you something to do before the date, such as a number to reach or a sign-off from another doctor.
Do I need to see my dentist, my heart doctor or anyone else before you will operate?
Why ask it
Clearance visits can take weeks to book and can move the surgery date, so get the full list today. Ask who sends the results to whom, and what this surgeon advises about dental work after the knee is in, because practices differ.
Which of my medicines do I stop beforehand, and on exactly which day?
Why ask it
Bring every bottle or a photo of each label, including blood thinners, diabetes and arthritis drugs, weight-loss injections and supplements. You want a date beside each name in writing, plus who tells you when to start again.
Hospital and pain
Is this done in a hospital or a surgery center, and would I go home the same day?
Why ask it
Same-day discharge is offered to some patients and not to others. Find out what makes you a fit, and what happens at a center with no overnight beds if you are not ready by evening.
Will I have a spinal or a general anesthetic, and who makes that call?
Why ask it
The surgeon may have a preference, but the anesthesiologist often decides with you, sometimes only on the morning itself, so ask when you will meet that doctor. Write down beforehand how earlier anesthetics went, whether you use a machine for sleep apnea and whether you have had back surgery, so none of it is recalled from a gurney.
How long does the operation take, and who tells my family how it went?
Why ask it
The person who will be in the waiting room should ask this one. Find out whether the time quoted counts the anesthesia and the recovery room or only the surgery, where to wait, and whether the surgeon comes out or phones. Leave a cell number at the desk.
Do you use a nerve block or numbing injections around the knee, and how long do they last?
Why ask it
The moment to plan for is when the numbness wears off, which may be at home in the middle of the night. Ask when to start the pills so you are ahead of it, and whether the block weakens the thigh enough to make standing risky.
How soon after the operation will I be standing, and who will be with me?
Why ask it
Many programs get people up within hours, with a therapist or nurse at their side. For the relative: ask to watch that first walk, because you will be the one steadying the walker a day or two later.
What do I have to be able to do before you send me home?
Why ask it
Have the list read out item by item, and describe your own staircase while you are at it: how many steps, which side the rail is on, whether there is a landing. The therapists can then rehearse your stairs and not a generic set. The relative should ask what they need to be shown too, such as getting you into the car.
What pain medicine will I go home with, and when do the opioids stop?
Why ask it
A real plan has names, doses, times of day and an end date. If you have had trouble with opioids, are in recovery or simply get sick on them, say so at this visit so the plan is built around that from the start.
Recovery
When will I feel like myself again, and when is the knee as good as it is going to get?
Why ask it
Expect two different dates: one for getting around the house and the grocery store, and often a much later one for when the knee stops improving. Get both, so that a hard stretch in the second month does not read to you as a failed operation. Then ask what most often slows people down.
Is there anything I should do to get stronger before surgery?
Why ask it
The buzzword is prehab. A useful answer is a short routine or a therapy referral, not 'stay active'. Ask to practice with the walker and learn the first-week exercises now, while you are not sore from an operation.
When does physical therapy start, and is it at home, at a clinic or both?
Why ask it
Find out who books the first session and whether it can be on the calendar before the surgery is. Clinic visits mean a ride each time for as long as you cannot drive, so count the trips and line up drivers.
How far should my knee bend and straighten at two weeks, six weeks and three months?
Why ask it
Ask for degrees and stick them on the fridge. Targets vary between surgeons, so use this one's, and ask what happens at each mark if you are behind: more sessions, a different exercise or a visit.
Early on, which matters more: bending the knee or getting it fully straight?
Why ask it
People chase the bend because it is easy to see, but hear what this surgeon puts first. The practical follow-ups are how to rest the leg, whether a pillow under the knee is allowed and how to stretch it straight at home.
How much pain during therapy is normal, and how much means I am overdoing it?
Why ask it
The exercises after a knee replacement have a reputation for hurting, and that is where a lot of people quietly stop. Get a rule you can apply alone at home, such as how long soreness may linger after a session, and ask about timing a dose before therapy.
How long will I be on a walker, and then a cane?
Why ask it
Expect a milestone, such as walking without a limp, more than a date. Ask who decides you are ready for the next step down, and whether to get the walker ahead of time so it is set to your height.
How much swelling, warmth and clicking should I expect, and for how many months?
Why ask it
A replaced knee can stay puffy and warm far longer than patients expect, and some click. Knowing this surgeon's version of ordinary lets you tell it apart from the redness, drainage or fever that needs a phone call. Ask for the icing and elevation routine too.
Will I have staples, stitches or glue, and when can I shower?
Why ask it
The answer plans your bathroom. Find out what kind of dressing goes on, whether it can get wet, and who takes staples or stitches out and where, since that is one more trip you cannot drive yourself to. Ask separately about baths and pools.
What can I do about sleep in the first few weeks?
Why ask it
Ask this before you are too tired to: which positions are allowed, whether moving the evening dose later helps, and when a full night is a realistic hope. A recliner is a common workaround, so check that it is all right for your knee.
Home and work
How much help will I need at home, and does someone have to stay overnight?
Why ask it
Some centers will not go ahead unless an adult stays with you for the first night or longer, so ask what the rule is here. The helper should ask what the job involves hour to hour: meals, pills, ice, getting to the bathroom at 3 a.m.
What should we set up in the house before surgery day?
Why ask it
Go through it room by room with the surgeon or the nurse: a firm chair with arms, a raised toilet seat, a shower seat, loose rugs, a bed on the ground floor. Then ask which items the hospital supplies, which you buy and whether any are covered.
If I can't manage at home at first, is a short stay in a rehab facility an option?
Why ask it
Raise this if you live alone, your bedroom is up a flight of stairs or your helper works days. Whether a stay is offered, and who pays, depends on your insurer or health system, so ask how it works where you are. If the surgeon prefers that you go straight home, ask what support they would arrange to make that safe.
When can I drive again?
Why ask it
It turns on which knee, whether the car is an automatic and whether you are still taking opioids. Get the surgeon's rule, then check whether your car insurer has one of its own, and plan rides for the gap.
When can I go back to my job, and will you put my restrictions in writing?
Why ask it
Describe the day and not the title: hours on your feet, ladders, kneeling, lifting, driving. Medical leave and disability forms depend on your employer and where you live, so ask the office who completes them and how long that takes.
When is it safe to fly or sit through a long car trip?
Why ask it
If a trip is already booked, give the date now, because it may change when the surgery should be. Ask what to do in the seat on the way, and whether the implant will set off airport metal detectors.
What will I owe for the surgeon, the facility, the anesthesia, the implant and the therapy?
Why ask it
The billing office usually has this answer, not the surgeon, and it depends entirely on your country and your plan. Ask for a written estimate, whether approval is needed in advance and who files for it, and whether therapy visits are capped.
Getting real answers at a knee replacement consultation
Practical guidance for the conversation itself
Before the consultation
Write down what the knee stops you doing
Surgeons decide partly on how much the knee limits your life, so arrive with specifics: how far you walk before stopping, whether it wakes you, the stairs you avoid, what you have given up. A list from the past month is more useful than 'it hurts a lot'.
Bring the history of this knee
Note earlier injuries and operations on it, the injections you have had and when, how long each helped, and the therapy you have done. If X-rays or scans were taken somewhere else, ask ahead whether the office can see them or whether you should carry copies.
Pick questions from the stage you are at
At a first visit the groups on whether to wait and on the operation matter most. Once a date is set, move to risks, the hospital, recovery and home. Mark eight or ten, put the three you most need answered at the top and leave space to write under each.
Ask what the office will hand you
Many joint programs have a printed packet or a class for patients, covering what to buy, when to stop eating and where to park. Ask for it early. It answers the logistics, which leaves the surgeon's time for the questions only the surgeon can answer.
If you are the relative going along
Agree on your job first
Ask the patient on the way there what they want from you: notes, the questions they forget, or quiet company. Then stick to it. The decision about the knee is theirs, even when you will be the one doing the lifting.
Write down numbers and names
Degrees of bend, dates for stopping medicines, the name of the anesthetic and the after-hours number are what get lost by evening. Record them as they are said, and read the list back before you leave the room.
Ask your own questions about the caring
You are entitled to know what the first two weeks ask of you: how many nights, how many drives to therapy, whether you will help with the bathroom or the stairs. If you cannot do all of it, say so here, where someone can help plan around it.
Notice what the patient plays down
People tell surgeons they are managing. If you have watched them come down the stairs backward or stop going out, ask their permission to mention it. The recommendation is only as good as the picture the surgeon is given.
Deciding without being rushed
You rarely have to answer that day
A knee replacement for arthritis is almost always a planned operation, so it is fair to say 'I would like to think about it' and ask how long you can reasonably take. If the surgeon believes waiting costs you something, ask them to say what.
When a second opinion earns its trip
It is most useful when you were told you need a total and wonder about a partial, when your pain and your X-ray do not seem to match, or when you felt hurried. Ask for your images and notes to be sent ahead, and check with your insurer or health system how a second visit is covered.
Choose the date around the recovery
The weeks after surgery need a helper, rides and time off, so work backward from those. Check the helper's calendar, the season if ice or heat makes walking hard where you live, and anything in the three months afterward that you would hate to miss.
Say what would make it worth it
Tell the surgeon the one or two things you want the new knee for. If the honest answer is that it will probably not deliver them, that is the most important fact of the visit, and you have it before the operation instead of after.
Where knee replacement plans go wrong
Borrowing someone else's recovery
A neighbor's hip or a friend's knee tells you little about yours. Hips and knees recover on different schedules, and two knees can too. Measure yourself against the targets this surgeon gave you.
Planning help for one week
Offers of help cluster around the first few days. The therapy trips go on for weeks after that, and you may not be driving for some of them. Ask how long people in your situation usually need a hand, then arrange cover for the whole stretch.
Leaving therapy to sort itself out
The first session can slip if nobody booked it, and surgeons tend to care a great deal about the early weeks of bending. Know before surgery where therapy happens, who arranged it and how you get there.
Hearing only the good half
It is natural to hold on to 'most people do very well' and let the talk of stiffness or lasting pain slide past. Have your companion note the risks as they are said, and read them once at home before you sign anything.