Your Guide to Knee Arthritis Treatments and Recovery

Recovering from knee replacement surgery can feel overwhelming, especially if you’re living with chronic pain or limited mobility from knee arthritis. Understanding what’s ahead can make the process smoother, more comfortable, and even empowering.

Recently, OrthoCarolina hosted an educational webinar on knee arthritis and knee replacement surgery, featuring board-certified orthopedic surgeon Dr. Boiwka. He discussed the latest advancements in treating knee arthritis, from non-surgical therapies to total knee replacement, and shared expert insight into what patients can expect after surgery, how to manage recovery, and the steps that lead to the best long-term results.

If you missed the session, you can watch the full webinar below for comprehensive insights directly from the surgeon.

Understanding Knee Arthritis and Osteoarthritis

Knee arthritis, specifically osteoarthritis, is the most common form of arthritis in the knee. Osteoarthritis results from the gradual wear and tear of cartilage in the joint, leading to pain, swelling, and stiffness.

Knee arthritis can impact one or more of the three compartments of the knee: the medial (inside), lateral (outside), and patellofemoral (kneecap) areas. Progressive cartilage loss can lead to bone-on-bone contact, bone spurs, and changes in knee alignment.

Symptoms of knee arthritis often include:

Dull, aching pain that worsens with activity
Stiffness, especially after periods of rest
Crepitus (grinding or clicking sensations)
Swelling or fluid accumulation (effusion)
Signs of instability or deformity in advanced cases

Diagnosis typically begins with a thorough history, physical exam, and X-rays, which reveal joint space narrowing, bone spurs, and other degenerative changes. Advanced imaging or lab tests may be used in select cases to rule out other causes of knee pain.

Non-Surgical Management of Knee Arthritis

Surgery is not the first step for most patients. Non-surgical treatments should be explored first. Non-surgical options include:

Physical therapy and low-impact exercise: Strengthening muscles around the knee improves stability and reduces pain. Recommended activities include aquatics, cycling, and elliptical use. High-impact exercises may exacerbate symptoms.
Weight management: Even modest weight loss can significantly reduce stress on the knee joint.
Bracing: Offloader braces or neoprene sleeves can reduce pain by supporting the knee and redistributing pressure.
Hot and cold therapy: Cold helps reduce swelling; heat eases stiffness and soreness before activity.
Injections: Corticosteroids are the gold standard for knee arthritis pain relief. Hyaluronic acid or PRP injections may be used selectively.
Genicular nerve ablation: A newer minimally invasive procedure that targets knee sensory nerves to reduce pain temporarily.

When Knee Replacement is Needed

Knee replacement surgery is considered when:

Conservative treatment no longer provides sufficient relief
Daily activities or work are significantly limited
Pain persists and negatively affects quality of life

Understanding Knee Replacement Surgery

Knee arthritis is one of the most common reasons patients seek knee replacement surgery, also known as total knee arthroplasty. Over time, the protective cartilage that cushions the joint wears away, leading to pain, swelling, and difficulty moving. When arthritis becomes severe and non-surgical treatments no longer provide relief it can restore comfort and mobility.

The procedure replaces the damaged portions of the knee joint caused by arthritis with prosthetic components made from metal and plastic. These artificial parts are designed to replicate natural movement, allowing the knee to bend, straighten, and rotate smoothly again.

There are two main types of knee replacements:

Total Knee Replacement: Replaces the entire knee joint.
Partial Knee Replacement: Replaces only the damaged compartment of the knee, preserving healthy tissue and bone.

Modern surgical techniques, including robotic-assisted and minimally invasive approaches, have made knee replacements safer, more precise, and associated with faster recovery times, particularly important for patients with advanced arthritis.

Surgery Day and the First 24 Hours

For many people living with moderate to severe knee arthritis, surgery day represents a turning point toward long-term relief. The procedure typically lasts one to two hours, and most patients are up and walking within a few hours with the help of a physical therapist.

Advancements in anesthesia and pain management now allow many patients to undergo knee replacement surgery for arthritis on an outpatient basis, returning home the same day. Others may stay in the hospital for one or two nights, depending on their health and support at home.

Immediately after surgery, patients typically:

Receive a waterproof bandage, allowing for showering within one to two days.
Use a walker or crutches to move safely.
Begin gentle exercises to prevent stiffness and promote circulation.

Early mobility is crucial to preventing complications such as blood clots and joint stiffness.

Managing Pain and Swelling

Pain management after knee replacement has improved dramatically, providing better comfort for arthritis patients during the crucial early recovery period. Surgeons use a combination of strategies to reduce discomfort, including:

Periarticular injections: Medication injected around the knee to numb pain for the first day or two.
Oral medications: Tylenol, anti-inflammatories, and nerve modulators may be used to minimize reliance on opioids.
Catheters or nerve blocks: Sometimes used to provide additional pain relief for several days after surgery.

Swelling can persist for weeks or even months. Elevating the leg, using compression, and icing the knee can help, and gentle movement encourages proper fluid drainage and circulation.

Timeline of Recovery

Recovery from knee replacement varies by individual, but most patients experience:

First 2 weeks: Walking with assistance, icing, and performing basic exercises.
Weeks 3-6: Transition from walker to cane, improved mobility, and increased independence in daily activities.
Weeks 6-12: Most patients regain the ability to perform normal daily activities, including shopping, light chores, and low-impact exercise.
3-4 months: Significant recovery of strength, range of motion, and function.
Up to 1 year: Full recovery, including the resolution of mild swelling, stiffness, or minor aches.

Driving can generally resume around six weeks after surgery, though individual readiness depends on pain levels, leg strength, and reaction time.

Long-Term Considerations

Knee replacements are designed to last. Registry studies indicate:

Total knee replacements remain functional in approximately 90% of patients at 20 years.
Partial knee replacements remain functional in 80-85% of patients at 15 years.

While high-impact activities like running or jumping are discouraged, low-impact exercises such as swimming, cycling, and golf are excellent for maintaining mobility and protecting your new joint. For many patients, these activities represent a return to the active lifestyle that arthritis once limited.

Lifestyle Tips: Exercise and Nutrition

Certain lifestyle choices can support recovery and protect knee health:

Exercise: Focus on low-impact activities and strength training for the quadriceps, hamstrings, and glutes. Yoga and swimming are excellent options.
Nutrition: A balanced diet rich in vegetables, lean protein, omega-3 fatty acids, and antioxidants may reduce inflammation and support healing. While no diet can reverse arthritis, good nutrition supports overall health and recovery.
Weight management: Maintaining a healthy weight reduces stress on the knee, extending the life of the implant.

The Path Forward

Knee arthritis can limit even the simplest activities, but with the right care, recovery is possible. Knee replacement surgery offers lasting pain relief and restored mobility for patients whose arthritis has advanced beyond non-surgical treatments.

Proper preparation, early mobility, physical therapy, and long-term lifestyle care all contribute to the best outcomes.

Orthopedic specialist inspecting knee replacement scar

If you’re living with knee arthritis and wondering whether knee replacement could help, schedule a consultation with an OrthoCarolina today. Our specialists can evaluate your knee, review treatment options, and create a personalized plan to help you move comfortably again—one step at a time.

Frequently Asked Questions

Do injections always work before surgery?

Injections such as cortisone or gel can provide relief, but effectiveness varies. Some patients experience months of improvement, while others see little benefit. If injections no longer relieve symptoms, surgery may be considered.