Total Knee Replacement Surgery

Reviewed by Greg Jaroszynski MD, FRCSC | Last updated May 2026

Total knee replacement surgery is usually a short operation, but safe recovery depends on anesthesia planning, fasting instructions, early mobilization, swelling control, wound care, and rehabilitation.

Key points

30-45 minutes
Spinal or general anesthetic
Follow the Pre-op Clinic fasting instructions
Home the same day or overnight stay
Walking shortly after surgery
Post-op rehabilitation 3-4 months

Surgery

Total knee replacement surgery typically takes about 30-45 minutes. It can be done under a spinal or general anesthetic. You will have the opportunity to discuss the pros and cons of either method of anaesthesia with the anaesthetist.

Please follow the fasting instructions given to you by the Pre-op Clinic. These instructions are important for your safety during anaesthesia. If you are unsure about when to stop eating or drinking, or whether to take a medication on the morning of surgery, contact the Pre-op Clinic or the surgeon's office before the day of surgery.

Hospital Stay

Hospital stay after total knee replacement has become much shorter. Currently, about half of patients are able to go home on the same day as surgery, once pain is controlled with tablets, vital signs are stable, walking is safe with the physiotherapist, and there is appropriate support at home. Going home the same day is not the goal for every patient; the goal is a safe discharge.

The other half of patients usually stay overnight. The most common reason is the need for medical monitoring, especially in patients with heart or lung disease, sleep apnea, diabetes, blood thinner use, frailty, or other medical conditions. Some patients also need more time because of dizziness, nausea, urinary retention, pain control, late surgery time, or home support concerns. This decision is made individually on the day of surgery.

Cryotherapy

Icing, or cryotherapy, is an important part of early comfort and swelling control after total knee replacement. It does not replace medication, walking, exercises, elevation, or physiotherapy, but it can help make the first days and weeks easier. Always protect the skin with a towel or cloth layer, and avoid prolonged direct ice contact.

There are several ways to use cryotherapy. Simple ice packs or gel packs are the least expensive. Cooler-based devices circulate cold water through a knee wrap and are usually more expensive than ice packs. Motorized cold-therapy devices, and devices that add intermittent compression, are generally the most expensive. Prices and rental options vary, so the best choice depends on cost, availability, comfort, and whether the device can be used safely at home.

My preferred supplier is Upper James Physio, telephone 905-383-3096, because they handle proper selection, delivery, and instructions for use. If it is not possible to obtain a cryotherapy machine, regular icing with an ice pack, gel pack, or similar cold pack is still helpful and is better than doing no icing at all.

Wound Staples Removal

Please make an appointment with your family physician for about 2 weeks after surgery to have the wound staples removed. If your family physician is not able to remove the staples, call the Joseph Brant Hospital Fracture Clinic at 905-632-3737 extension 4110.

Rehabilitation

You will usually be encouraged to stand and walk shortly after surgery, using a walker to take some of the load off the operated knee. Early walking helps reduce stiffness and supports a safe discharge plan.

The total rehabilitation time is approximately 3 to 4 months. During that time, there will be certain things that you should and should not do. They will be discussed with you at the appropriate times. On average, people can expect to return to driving about 6 weeks after surgery and to sedentary occupations around the 3rd month.