A total knee replacement is not really a replacement, it is more of a resurfacing of the knee.  The end of the thigh bone is shaved off and a metal cap is put in its place, held onto the bone with cement.  The top of the shin bone (tibia) is shaved off and a metal tray is placed, held onto the bone with cement.  A plastic (polyethylene) liner is snapped into the metal tray.  The metal cap articulates with the plastic liner.  A portion of the knee cap is shaved off and replaced with a plastic button.

     The new knee is designed to bend a in most cases patients regain the amount of bend they had prior to surgery and may even end up with a little more motion.  It is not always possible to improve the amount of bend and sometimes may actually lose                                  a little bit of motion if there is a lot of scar tissue.

     When the pain or stiffness becomes severe and you lose the ability to perform normal daily activities such as going on walks, going to the store or getting in/out of the car.  People may also notice difficulty with other types of activities such as golfing, playing tennis, riding a bicycle or going on hikes.  Most patients have tried over the counter medications, a cortisone injection or hyaluronic acid injections.  The "need" for a knee replacement goes beyond the xray and just because your xray may show arthritis, you may not "need" one until your quality of life is                                          diminished.  Patients usually know when they are ready for a knee                                 replacement.