Total Knee Replacement Surgery

Total knee replacement relieves pain and restores function for people whose knees have been damaged by arthritis, injury, or wear. Over 700,000 knee replacements are performed in the United States each year, making it one of the most common and successful elective surgeries. The majority of patients report significant pain relief and improved ability to walk, climb stairs, and return to the activities they enjoy.

Dr. Leo Zalikha performs total knee replacement with robotic-assisted technology, which allows for individualized implant positioning based on each patient’s unique anatomy. His goal for every knee replacement is a joint that feels natural, bends well, and lasts.

Knee replacement is recommended when nonsurgical treatments are no longer controlling pain or maintaining function. Dr. Zalikha always starts with conservative management when appropriate, including physical therapy, anti-inflammatory medications, injections, bracing, Weight Optimization & Prehab, and activity modification.

Surgery may be the right next step if:

• Knee pain limits walking, standing, or using stairs
• Pain persists at rest or interferes with sleep
• The knee feels stiff and you cannot fully straighten or bend it
• X-rays demonstrate significant arthritis with bone-on-bone contact

Dr. Zalikha evaluates each patient individually. Some patients with moderate arthritis are better served by a partial knee replacement, which preserves healthy bone and ligaments. The right procedure depends on the pattern of arthritis, your anatomy, and your goals.

During total knee replacement, the damaged surfaces of the knee joint are resurfaced with metal and polyethylene (medical-grade plastic) components. The end of the femur (thighbone) is capped with a metal component, the top of the tibia (shinbone) is fitted with a metal tray and plastic liner, and the undersurface of the kneecap is typically resurfaced with a plastic button.

The surgical plan is tailored to your knee and implant. Dr. Zalikha can explain which soft tissues are preserved or addressed during your procedure. The goal is to create a smooth, stable, well-aligned joint that moves naturally.

Dr. Zalikha uses robotic-assisted technology for total knee replacements. Before surgery, a CT scan generates a detailed 3D model of your knee. Using this model, Dr. Zalikha plans the precise size, position, and alignment of each implant component.

During surgery, the robotic system provides real-time guidance, helping the surgeon execute the plan with sub-millimeter accuracy. This level of precision matters because implant alignment directly affects how the knee feels, how it bends, and how long it lasts. The surgeon maintains full control throughout. The robotic arm is a precision instrument, not an independent operator.

Benefits of robotic-assisted knee replacement include:

• Implant positioning tailored to your individual anatomy
• More consistent alignment and balance of the knee
• Preservation of healthy bone and soft tissue
• Potentially improved early function and satisfaction

Not every arthritic knee needs a total replacement. If arthritis is limited to one compartment of the knee (typically the inner side), a partial knee replacement may be a better option. Partial knee replacement preserves the healthy portions of the joint, including the cruciate ligaments, and typically allows for a quicker recovery with a more natural feel.

Dr. Zalikha evaluates knee X-rays and performs a thorough exam to determine whether a partial or total replacement is the right choice.

Preparation improves outcomes. Dr. Zalikha's team provides a pre-operative checklist covering medical optimization, medication management, home setup, and what to expect on surgery day. Patients who arrive at surgery in better physical condition, including adequate weight optimization and leg strength, tend to recover faster.

Total knee replacement typically takes about 60 to 90 minutes of surgical time. Many patients are candidates for outpatient (same-day) knee replacement and return home the day of surgery. Others spend one night in the hospital. The decision depends on your overall health, support at home, and comfort level. Physical therapy begins the day of surgery. You will stand and walk with assistance before leaving the surgical facility.

Physical therapy continues after you return home, progressing from a walker to a cane as strength and balance improve. Most patients resume light daily activities over the first several weeks and continue building strength in the months that follow. Dr. Zalikha’s team follows your progress at scheduled visits. See the knee replacement recovery guide for a week-by-week timeline.

Total knee replacement is a well-established procedure with high success rates, but surgery carries inherent risks. These include infection, blood clots, stiffness, nerve or blood vessel injury, persistent pain, and the possibility of future revision surgery. Dr. Zalikha discusses each risk during your consultation and implements evidence-based protocols to minimize complications.

Factors that affect outcomes include body weight, diabetes control, smoking status, and adherence to the post-operative therapy program. Patients who address modifiable risk factors before surgery give themselves the best chance at a good result.

For an outpatient total knee replacement (CPT 27447), Medicare’s national averages are $14,275 in a hospital outpatient department versus $10,552 in an ambulatory surgery center, with the patient’s share averaging about $1,967 and $2,109 respectively before any supplemental coverage [1]. Those figures come from Medicare’s Procedure Price Lookup and are national averages, not quotes for any particular facility. The surgical setting also determines which part of Medicare applies: outpatient surgery falls under Part B, where you pay 20% of the Medicare-approved amount after the $283 annual deductible, while an inpatient admission falls under Part A, with a $1,736 deductible per benefit period in 2026, per the CMS 2026 premiums and deductibles fact sheet [2][3]. A Medigap or Medicare Advantage plan can change these amounts significantly. Our guide to Medicare coverage for knee and hip replacement walks through the rules in plain language.

With commercial insurance, peer-reviewed claims studies put the average out-of-pocket cost for a knee replacement at roughly $2,500 to $3,000, a figure that has been rising year over year, and high-deductible plans can push your share well above that mean [4][5]. What I tell my patients is that averages are benchmarks, not bills: your own deductible, coinsurance, and out-of-pocket maximum determine what you will actually pay, so call your insurer, ask whether prior authorization is required, and get those numbers in writing before you schedule surgery. For a closer look at how prices vary across our region, see our breakdown of knee replacement costs in California.

References

1. Procedure Price Lookup: Total knee arthroplasty (CPT 27447), national average costs in hospital outpatient departments and ambulatory surgical centers. Medicare.gov, U.S. Centers for Medicare & Medicaid Services. medicare.gov/procedure-price-lookup (accessed June 11, 2026).
2. Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles. CMS.gov fact sheet, November 14, 2025. cms.gov/newsroom.
3. Medicare.gov. Outpatient hospital services. U.S. Centers for Medicare & Medicaid Services. medicare.gov/coverage/outpatient-hospital-services.
4. Durand WM, et al. J Am Acad Orthop Surg. 2022;30(14):669-675. PMID: 35797680.
5. Singh P, Marrache M, Kim AH, Williams S, Hegde V, Khanuja HS. Total Knee Arthroplasty Out-of-Pocket Costs on the Rise: A Nationwide Analysis of Financial Burden and Regional Disparities. J Arthroplasty. 2026;41(6):1637-1642. PMID: 41067462.
6. Mantel J, Ruppenkamp JW, Cantu M, Holy CE. Total knee arthroplasty in the outpatient vs inpatient settings: impact of site of care on early postoperative economic and clinical outcomes. J Orthop Surg Res. 2023;18(1):273. PMID: 37013560.