Total Knee Replacement Surgery in Sydney
Total knee replacement surgery in Sydney is performed by Dr Jonathan Negus, a fellowship-trained orthopaedic knee surgeon based at St Leonards.
For patients across Sydney's north shore and central coast experiencing chronic knee pain, stiffness, or advanced arthritis, total knee replacement often provides a pathway back to comfortable movement when non-surgical options are no longer effective.
Below we outline what total knee replacement involves, when it’s recommended, how to prepare, and what recovery typically looks like. Whether you're getting ready for surgery yourself or supporting a loved one, this guide explains what to expect before and after knee replacement surgery.
What Is Knee Arthritis and Why Does It Lead to Surgery?
Knee arthritis is a degenerative joint condition, most commonly caused by osteoarthritis, that gradually wears away the protective cartilage inside the knee. As the cartilage thins, bones begin to rub together, resulting in pain, swelling, and stiffness. Other types of arthritis, such as rheumatoid or post-traumatic arthritis, can also damage the joint over time.
In the early stages, arthritis might feel like occasional stiffness, especially after rest or cold weather. Over time, pain can become constant, even at rest or during sleep. The joint may feel unstable or misaligned, and everyday movements like standing, sitting, or walking short distances can become challenging.
When these symptoms start affecting your ability to walk, sleep, or move comfortably, and when physiotherapy, medications, or injections no longer help, a knee replacement may be considered. For patients with isolated cartilage damage, partial knee replacement or other procedures may be explored. However, for widespread joint damage, total knee replacement treatment is often the most effective surgical option to restore joint movement and quality of life.
What Is Total Knee Replacement Surgery?
A total knee replacement, also known as total knee arthroplasty surgery, is a procedure that involves removing the damaged knee joint surfaces and replacing them with artificial implants.
These implants are shaped to mimic normal knee function and relieve symptoms such as pain, tightness, and limited movement. The procedure involves:
- Metal components are applied to the ends of the thigh bone and shin bone, creating smooth new surfaces for joint movement.
- Inserting a smooth plastic spacer between the metal components to restore fluid movement.
- In certain cases, the underside of the kneecap (patella) may also be lined with a prosthetic surface if the joint damage extends to that area.
These implants are engineered to be highly durable and biocompatible. Your surgeon may choose a cemented or uncemented fixation method. Cemented joints are more common and offer immediate stability, while uncemented joints allow bone to grow into the implant over time.
In some cases, bilateral knee replacement may be advised when both knees are severely affected. This can be done during a single operation or spaced out over several months, depending on your health and recovery goals.
Who Is a Candidate for Total Knee Replacement Surgery?
A total knee replacement may be recommended for you if you meet the following criteria:
- You have moderate to severe arthritis confirmed by X-ray or MRI
- You experience persistent pain or stiffness, even when resting
- Non-surgical treatments like medication, exercise, and injections no longer relieve your symptoms
- You struggle with basic activities like walking, climbing stairs, or getting in and out of a chair
Conditions treated include: Read More
- Osteoarthritis (the most common)
- Rheumatoid arthritis
- Post-traumatic arthritis due to fractures or ligament injuries
Total knee replacement is among the most commonly performed orthopaedic procedures in Australia
. According to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) annual report for 2024, over 1.1 million knee replacements have been recorded since 1999, with a 19.2% increase in knee replacements in the 12 months leading up to December 31, 2023.
Preparing for Surgery: What to Know Before You Commit
Preparation plays a critical role in both surgical success and recovery. Your surgeon and hospital team will guide you through pre-operative planning, which often includes:
- Medical checks and imaging: Blood tests, X-rays, and possibly a heart screening to ensure you’re fit for surgery
- Home adjustments: Setting up a safe environment with grab rails, clear walking paths, and items within easy reach
- Exercise programs: Some surgeons recommend “prehab” to strengthen muscles around the knee before surgery
- Medication review: You may need to pause certain prescriptions, especially blood thinners or
anti-inflammatory drugs
You’ll also discuss any preferences or eligibility for minimally invasive surgery (MIS), which uses smaller incisions and may lead to quicker recovery. However, not all patients are suitable candidates, and traditional techniques still remain the standard approach in most cases.
What Happens During a Total Knee Replacement?
The procedure is performed in a sterile hospital theatre under general or spinal anaesthesia. Surgery duration is usually between one and two hours, though this can vary based on your individual needs and whether one or both knees are being treated.
Key surgical steps:
- The surgeon removes the damaged bone and cartilage from the lower femur and upper tibia to allow proper placement of the artificial joint components
- Precision-matched metal implants are attached to recreate a smooth joint surface
- A plastic spacer is inserted to allow the natural gliding of the joint
- In some cases, the patella is resurfaced or reshaped
Some surgeons use robotic-assisted or computer-navigated tools to ensure precise alignment, especially in complex or repeat surgeries. Your surgeon will explain which techniques are recommended for you.
If you're exploring the use of surgical technology, it may help to understand how robotic knee replacement differs from conventional surgery, including how precision tools may influence joint alignment and recovery.
The Day of Your Operation: What to Expect at the Hospital
You’ll typically arrive early on the day of your procedure. After checking in, you’ll meet your anaesthetist and surgical team, and complete final consent and safety checks.
Following surgery, you’ll be monitored in the recovery room as part of your post-op knee replacement care plan, where nurses will check your blood pressure, pulse, and wound site. Pain management is a top priority, and your care team will tailor medication to keep you comfortable without over-sedation.
Immediately After Surgery: In-Hospital Recovery
Within 24 hours of surgery, most patients begin light physiotherapy and assisted walking with the help of a nurse or physiotherapist. Movement is encouraged early to:
- Prevent blood clots
- Reduce joint stiffness
- Start building muscle strength
You may be fitted with compression stockings or a blood-thinning injection to reduce clot risk. The average hospital stay ranges from 2 to 5 days, depending on your age, recovery speed, and any pre-existing health conditions.
Going Home: Post-Op Knee Replacement Care
Once discharged, post-op knee replacement care at home becomes the focus. You’ll be given detailed instructions for:
- Wound care: Keeping the incision site dry and clean until your stitches either dissolve on their own or are taken out during a follow-up visit
- Pain management: Taking medications as prescribed and using ice therapy
- Mobility aids: Crutches or a walker may be used for the first few weeks
- Home exercises: Continuing rehab daily to regain strength and movement
It’s important to watch for warning signs like fever, increased redness, fluid leaking from the wound, or unusual calf pain. These could indicate infection or deep vein thrombosis (DVT). Prompt medical review is recommended in these cases.
Alongside monitoring your health, setting up a safe and accessible home environment may also support recovery—making your home recovery-friendly after surgery can help reduce avoidable risks and make everyday tasks more manageable during the early weeks.Read Less
Recovery Timeline: What’s Normal and What’s Not
While knee replacement recovery time varies by individual, general expectations include:
- Week 1–2: Walking short distances with support, managing swelling, starting gentle knee bends
- Week 3–6: Improving your range of motion, walking longer distances, beginning light strength work
- 3–6 months: Many patients return to work, depending on job demands, and resume most daily activities with increased confidence.
- 6–12 months: Full recovery, including strength and endurance, may continue to improve up to 12 months post-surgery.
Fatigue and mild discomfort may linger for several months during the total knee replacement recovery period, but gradual progress is expected with consistent physiotherapy. Patience and consistent rehabilitation are key to achieving your goals.
Managing Pain and Building Strength at Home
Pain is a natural part of recovery, but it should steadily improve with time. Your doctor may prescribe a mix of:
- Paracetamol or anti-inflammatories
- Stronger opioids, if required, for the short term
- Icing, elevation, and rest between rehab sessions
Exercise is just as crucial as rest. Your physio will teach you how to:
- Strengthen the quadriceps and hamstrings
- Regain balance and coordination
- Walk confidently and reduce limping
Aim for short, regular exercise sessions multiple times a day rather than long sessions that increase fatigue.
Getting Back to Life: Work, Driving, and Daily Activities
Work:
- Desk-based jobs: May resume around 6 weeks post-op
- Physically active roles: May require 3+ months, depending on strength and mobility
Driving:
- You’ll need to safely operate pedals, typically 2 to 3 weeks post-op for a left knee and 6 weeks post-op for a right knee (always check with your doctor and insurer first)
Daily activities:
- Many people return to grocery shopping, home cooking, and social outings within 6 to 8 weeks. However, high-energy tasks or long walking distances may take longer to regain.
Risks and Complications: What to Be Aware Of
While most people recover well, every surgical procedure carries risks. Possible complications include:
- Infection, which may occur either at the incision or deeper within the new joint structure
- Blood clots (DVT or pulmonary embolism)
- Implant loosening over time
- Persistent pain or stiffness
- Allergic reactions (rare, related to implant materials)
Talk to your knee surgeon about your individual risk factors and how these are managed.
Long-Term Outcomes and Benefits of Knee Replacement
Most patients experience:
- Significant pain relief
- Improved joint alignment and function
- A return to walking, travel, and social engagement
Knee replacement can make everyday life easier, but it’s not a perfect copy of a natural joint. You may still notice some stiffness when kneeling or bending, and strength may take several months to rebuild fully.
How Long Does a Knee Replacement Last?
Many patients ask: how long does a knee replacement last? Studies suggest modern implants last:
- More than 20 years in 85–90% of people.
- Some last even longer, depending on weight, joint care, and activity level.
Keeping a healthy weight, avoiding high-impact sports, and staying active with low-impact exercise can help extend the life of your replacement.
Is Total Knee Replacement Right for You?
While not an overnight cure, Total knee replacement surgery often provides a long-term pathway to reduced discomfort and greater ease in movement. Your suitability will depend on your symptoms, imaging results, general health, and goals, best assessed by a
qualified total knee replacement surgeon.
Discuss your options thoroughly with your GP or an orthopaedic surgeon. Ask about expected outcomes, surgical technique, rehabilitation plans, and whether the procedure aligns with your lifestyle and recovery expectations. You can verify your surgeon’s credentials via
AHPRA’s public register.
Other Knee Treatments
← Back to Knee Surgery Overview
Robotic Knee Surgery
Computer-assisted planning can enhance implant fit and alignment during total replacement.
See Robotic BenefitsPartial Knee Replacement
An option when arthritis is limited to one compartment—sometimes an alternative to total replacement.
Explore Partial ReplacementRecovery After Knee Surgery
Guidance specific to total knee recovery: pain control, exercises and realistic timelines.
Plan Your Recovery
Book a Consultation
Dr Negus consults at St Leonards (North Sydney) and Gosford (Central Coast). If you’re considering total knee replacement surgery in Sydney and want to know if it’s the right option for your knee condition, Dr Jonathan Negus and his team can provide clear, evidence-based advice. With extensive experience in total knee procedures, we’re here to support your recovery with trusted care, precision, and a focus on preserving natural movement.
FAQs: Total Knee Replacement Surgery
Fellowships and visitations
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- Professor Fares Haddad - UCLH & Princess Grace, London - Hip & knee surgery
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- Mr Andy Williams - Fortius Clinic, London - Sports surgery for elite athletes
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- Mr Will Jackson - Nuffield Orthopaedic Centre, Oxford - Partial knee replacement
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- Mr John Timperley - Exeter Hip Unit, UK - Hip surgery
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- Professor Graichen - Lindenlohe, Germany - Brainlab navigated arthroplasty
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- Dr Kristoff Corten - Genk Belgium - Direct anterior approach for hip surgery
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- Professor Ian McNamara - Norwich, UK - Patellofemoral knee surgery
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- Mr Thomas Quick - Stanmore, London - Peripheral nerve injury
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- Dr Jonathan Herald - Sports and knee arthroplasty fellowship, Sydney
