If you’re finding that knee pain is slowly creeping into every aspect of your life—making it harder to walk, sleep, or enjoy the things you love—then you’re not alone. As a Consultant Orthopaedic Surgeon specialising in total knee replacement surgery in Dorset, I meet patients every week who’ve been trying to “just get on with it” for far too long.

In this detailed guide, I’ll walk you through exactly what total knee replacement surgery involves, who it’s for, how it works, and what to expect—so you can make an informed decision, armed with knowledge and clarity.

Whether you’re considering surgery for yourself or supporting a loved one through the process, you’ll find real answers here.

You may have been told that your pain is due to knee osteoarthritis—the most common reason for knee replacements. This is a condition where the cartilage that cushions your joint wears away, leading to stiffness, inflammation, and grinding pain.

But it’s not just about the X-rays. People come to me when:

• They can’t sleep at night because of their knee pain.
• Walking any distance feels like a mountain.
• Their knee starts to feel unstable, like it might give way.
• They’re relying on painkillers just to get through the day.
• Friends and family are noticing a limp they didn’t have before.

If that sounds like you, it may be time to explore your options.

A total knee replacement replaces all sides of the joint—the medial, lateral and patellofemoral compartments. This is the most common type, especially for patients with widespread arthritis.

A partial knee replacement may be suitable if only one side of your knee is damaged—typically the inner (medial) side. But for this to work well, your ACL must be intact and functioning. If your arthritis is advanced, that ligament may already be worn out, making a full replacement the better option.

On the day of your operation, you’ll arrive at the hospital and be reviewed by myself and the anaesthetic team. We’ll go through everything again to make sure you’re completely clear on the procedure.

In theatre, I make a precise incision at the front of the knee, and using specialised guides and instruments, I remove the damaged bone and cartilage. The replacement components are cemented into place, and a plastic wear plate is inserted between them to allow smooth gliding motion.

Every measurement, every implant position is meticulously planned and double-checked to ensure you come out with the best possible range of movement and stability.

Before the knee is closed, I fully flex and extend your new knee to make sure it moves smoothly and feels stable. I use dissolvable sutures coated with antiseptic material to reduce infection risk. These don’t need to be removed later—your body will naturally absorb them.

Not all knee replacements are the same. The most common (and reliable) type I use is a fixed-bearing knee replacement.

Fixed-Bearing Knees

The plastic component stays locked in place, securely attached to the metal tibial baseplate. This setup offers excellent stability and durability, which is why I favour it in most cases.

Mobile-Bearing Knees (a.k.a. Rotating Platform or Pivoting Knees)

These allow some movement of the plastic bearing as your knee moves. While this might seem more “natural,” studies have shown they may wear more quickly and have higher failure rates. For that reason, fixed bearings remain the gold standard.

Most of my patients receive a spinal anaesthetic, which blocks pain from the waist down. You can also opt for light sedation if you’d prefer to be unaware during the operation.

Your anaesthetist will often perform a nerve block too, which significantly reduces pain for the first 24–48 hours. I also inject local anaesthetic into key parts of the knee during the procedure to help you stay as comfortable as possible.

You’ll typically be up and walking with the physiotherapists within six hours of surgery. It may feel surreal to stand on your new knee that soon—but early mobilisation helps reduce complications and speeds up healing.

Yes, it’s a big operation. And yes, you will feel tired and sore afterwards. That’s completely normal. In the first few days, the swelling and stiffness can feel daunting, but we manage this with regular painkillers and ice therapy. I encourage gentle movement to keep the knee from stiffening up.

Before discharge, our physiotherapy team will teach you how to manage stairs and everyday tasks safely. At home, it’s essential not to push too hard, too soon. Give yourself permission to rest—your body is recovering from major surgery.

Most people are walking without crutches at home by around four weeks, though you might need one crutch outside for longer distances until six weeks.

If you’ve had your left knee done and drive an automatic car, you might be able to drive after 4 weeks. For right knees, expect to wait 6 weeks.

Flying should be avoided for at least 3 months, especially long-haul, due to the increased risk of blood clots.

The implants I use—such as the Stryker Triathlon Knee—have a proven track record. Studies show a 95% survival rate at 10 years, and many patients go well beyond that. These are robust, well-engineered components designed for longevity.

Technically, yes. But running on a knee replacement will likely feel uncomfortable—it’s a mechanical joint, after all. If you must run, stick to grass or soft surfaces and listen to your body.

Kneeling is allowed, though it may feel odd due to the sensation of metal under your skin. Using a cushion helps.

I recommend:

• Cycling (indoor or outdoor)
• Cross trainer or Elliptical machine 
• Swimming (front crawl is better than breaststroke initially)

These activities are low impact and ideal for building strength and maintaining joint mobility.

Like any operation, knee replacements carry risks. I always take time to talk these through with you in detail. Potential procedure specific complications include:

• Wound healing issues or infection
• Swelling or bruising
• Blood clots (DVT)
• Persistent pain
• Instability or implant loosening
• Rarely, revision surgery may be needed
• Tendon or ligament damage
• Fracture

But with the right preparation, surgical technique, and aftercare, these risks are low.

I’m a fellowship-trained joint replacement surgeon, specialising in both hip and knee replacements. I perform a high volume of procedures every year, and I use only tried-and-tested implants registered with the National Joint Registry.

You’ll receive personalised, consistent care from your first consultation through to surgery and recovery. No conveyor belt approach. Just clear communication, expert surgical skill, and evidence-based practice.

Most of my patients describe a moment when they realise enough is enough. Maybe it’s avoiding stairs. Maybe it’s waking up again at 3am in pain. Maybe it’s the growing reliance on a stick or painkillers.

If your knee pain is affecting your freedom, your confidence, or your quality of life, then it may be time to talk about surgery.