From the Guidelines
A knee replacement surgery typically takes around 1 to 2 hours to complete. The procedure involves removing damaged cartilage and bone from the knee joint and replacing them with artificial components, as seen in the case of a patient with moderate to severe tricompartmental degenerative changes who underwent total knee arthroplasty (TKA) 1. The exact duration can vary depending on several factors, including the complexity of the case, the patient's anatomy, the type of implant being used, and the surgeon's experience.
Some key considerations that can affect the duration of the surgery include:
- The use of minimally invasive techniques, which may reduce the surgical time
- The presence of significant deformity or previous surgeries, which can increase the complexity and duration of the procedure
- The type of anesthesia used, such as spinal anesthesia with a supplemental adductor canal block, which can help minimize opiate usage and postoperative pain 1
- The use of tranexamic acid to minimize postoperative blood loss, which can also impact the overall surgical time 1
It's also important to note that the actual surgical time does not include the preparation before surgery, such as anesthesia administration, positioning, and sterilization, or the recovery time in the post-anesthesia care unit, which can add several more hours to the overall hospital experience on the day of surgery. Overall, the goal of knee replacement surgery is to improve the patient's quality of life by reducing pain and improving mobility, and the surgical time is just one aspect of the overall treatment plan.
From the Research
Overview of Knee Replacement Surgery
- Knee replacement surgery, also known as total knee arthroplasty (TKA), is a surgical procedure to replace a damaged or diseased knee joint with an artificial one.
- The length of time it takes to perform a knee replacement surgery can vary depending on several factors, including the type of anesthesia used, the complexity of the procedure, and the patient's overall health.
Anesthesia and Surgery Time
- A study published in 2023 2 found that spinal anesthesia was associated with a slightly higher likelihood of having a longer operative time, with an odds ratio of 1.075.
- Another study published in 2025 3 found that patients who received mepivacaine spinal anesthesia had a faster median time to return of motor function, with a median time of 210 minutes compared to 229 minutes for those who received bupivacaine spinal anesthesia.
- A study published in 2013 4 found that the length of surgery was shorter in the spinal anesthesia group, with a mean time of 96 minutes compared to 100 minutes for the general anesthesia group.
Hospital Stay and Recovery
- The 2023 study 2 found that spinal anesthesia was associated with a lower risk of having a length of stay greater than 3 days, with an odds ratio of 0.470.
- A study published in 2024 5 found that patients who received spinal anesthesia had a shorter length of stay in the post-anesthesia care unit, with a mean time of 206 minutes for those who received mepivacaine spinal anesthesia.
- The 2022 study 6 found that patients who received spinal anesthesia had a lower risk of 30- and 90-day readmissions, with odds ratios of 1.4 and 1.5, respectively.
Complications and Risks
- The 2023 study 2 found that spinal anesthesia was associated with lower rates of 90-day readmission and 90-day all-cause revision, with odds ratios of 0.845 and 0.506, respectively.
- The 2013 study 4 found that the spinal anesthesia group had a lower unadjusted frequency of superficial wound infections, blood transfusions, and overall complications.
- The 2022 study 6 found that spinal anesthesia was associated with a lower risk of any revision and any reoperation, with odds ratios of 1.2 and 1.3, respectively.