Reading as
Plain-language core. Switch lenses to reveal technical or purchasing detail.
All topics
  1. What it is
  2. Who it helps
  3. Timing
  4. The procedure
  5. Patient journey
  6. Recovery supplies
  7. Implant designs
  8. Side-by-side
  9. Robotics and alignment
  10. US manufacturers
  11. What the evidence says
  12. Value analysis
  13. Questions to ask
  14. Resources
  15. Glossary
  16. References

Sources

References

Sources 1 to 44 and 51 are peer-reviewed articles retrieved from PubMed, each linked to its DOI. Sources 45 to 50 are patient-education pages from professional societies, hospitals and the US government. Manufacturer sources are linked on each manufacturer card. Studies with an industry co-author are marked.

  1. Price AJ, et al. Knee replacement. Lancet. 2018;392(10158):1672-1682. doi:10.1016/S0140-6736(18)32344-4
  2. Shichman I, et al. Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040-2060. JB JS Open Access. 2023;8(1):e22.00112. doi:10.2106/JBJS.OA.22.00112
  3. Gunaratne R, et al. Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature. J Arthroplasty. 2017;32(12):3854-3860. doi:10.1016/j.arth.2017.07.021
  4. Bourne RB, et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57-63. doi:10.1007/s11999-009-1119-9
  5. Beswick AD, et al. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2(1):e000435. doi:10.1136/bmjopen-2011-000435
  6. Evans JT, et al. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):655-663. doi:10.1016/S0140-6736(18)32531-5
  7. Bayliss LE, et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet. 2017;389(10077):1424-1430. doi:10.1016/S0140-6736(17)30059-4
  8. Sharkey PF, et al. Why are total knee arthroplasties failing today: has anything changed after 10 years? J Arthroplasty. 2014;29(9):1774-1778. doi:10.1016/j.arth.2013.07.024
  9. Kurtz SM, et al. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res. 2010;468(1):52-56. doi:10.1007/s11999-009-1013-5
  10. Januel JM, et al. Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis: a systematic review. JAMA. 2012;307(3):294-303. doi:10.1001/jama.2011.2029
  11. Sidhu VS, et al. Effect of aspirin vs enoxaparin on symptomatic venous thromboembolism in patients undergoing hip or knee arthroplasty: the CRISTAL randomized trial. JAMA. 2022;328(8):719-727. doi:10.1001/jama.2022.13416
  12. Borazjani R, et al. Aspirin versus other anticoagulants for the initial prevention of venous thromboembolism following elective total hip and knee arthroplasty: an umbrella review and meta-analysis. J Arthroplasty. 2026;41(1):225-237. doi:10.1016/j.arth.2025.06.032
  13. Olsen AA, et al. The cost of stiffness after total knee arthroplasty. J Arthroplasty. 2023;38(4):638-643. doi:10.1016/j.arth.2022.10.040
  14. Prasad AK, et al. Cemented vs. cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis. EFORT Open Rev. 2020;5(11):793-798. doi:10.1302/2058-5241.5.200030
  15. Paull TZ, et al. Uncemented total knee arthroplasty in the State of Michigan has higher rates of revision through 5-year follow-up. J Arthroplasty. 2025;40(7S1):S263-S270. doi:10.1016/j.arth.2025.03.007
  16. Chen F, et al. What is the survivorship of TKA with a twin-peg or spikes-and-keel cementless implant compared with cemented? A registry-based cohort study. Clin Orthop Relat Res. 2025;483(7):1288-1298. doi:10.1097/CORR.0000000000003385
  17. Finch D, et al. National trends in use and complications of cemented, cementless, manual, and robotic-assisted total knee arthroplasty: 2016-2022. J Knee Surg. 2026;39(4):208-217. doi:10.1055/a-2712-4129
  18. Verra WC, et al. Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis. Cochrane Database Syst Rev. 2013;(10):CD004803. doi:10.1002/14651858.CD004803.pub3
  19. Migliorini F, et al. No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30(9):3138-3154. doi:10.1007/s00167-022-07065-5
  20. Simpson CJRW, et al. Patellar resurfacing versus retention in cruciate-retaining and posterior-stabilized total knee arthroplasty. Bone Joint J. 2023;105-B(6):622-634. doi:10.1302/0301-620X.105B6.BJJ-2022-0970.R2
  21. Grassi A, et al. Patellar resurfacing versus patellar retention in primary total knee arthroplasty: a systematic review of overlapping meta-analyses. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3206-3218. doi:10.1007/s00167-018-4831-8
  22. Abdelaziz O, et al. Comparative pain relief and functional outcomes following robotic-assisted versus conventional total knee arthroplasty: a GRADE-assessed meta-analysis with meta-regression of randomized controlled trials. J Robot Surg. 2026;20(1). doi:10.1007/s11701-026-03934-0
  23. Onggo JR, et al. Robotic-assisted total knee arthroplasty is comparable to conventional total knee arthroplasty: a meta-analysis and systematic review. Arch Orthop Trauma Surg. 2020;140(10):1533-1549. doi:10.1007/s00402-020-03512-5
  24. Blackman BW, et al. Kinematic and mechanical alignment yield similar outcomes in total knee arthroplasty: a systematic review and a meta-analysis of randomized controlled trials. J Arthroplasty. 2026;41(10):3188-3198.e1. doi:10.1016/j.arth.2026.01.036
  25. Gusho C, et al. No superiority of total knee arthroplasty alignment philosophies: a network meta-analysis comparing mechanical, anatomical, kinematic, restricted kinematic, and functional alignment among randomized controlled trials. JBJS Rev. 2025;13(8):e25.00101. doi:10.2106/JBJS.RVW.25.00101
  26. Beard DJ, et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet. 2019;394(10200):746-756. doi:10.1016/S0140-6736(19)31281-4
  27. Wilson HA, et al. Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. BMJ. 2019;364:l352. doi:10.1136/bmj.l352
  28. Bemelmans YFL, et al. Safety and efficacy of outpatient hip and knee arthroplasty: a systematic review with meta-analysis. Arch Orthop Trauma Surg. 2022;142(8):1775-1791. doi:10.1007/s00402-021-03811-5
  29. Gordon AM, et al. The effect of COVID-19 on elective total knee arthroplasty utilization, patient comorbidity burden, and complications in the United States: a nationwide analysis. J Am Acad Orthop Surg. 2022;30(24):e1599-e1611. doi:10.5435/JAAOS-D-22-00193
  30. Wang Z, et al. Effectiveness of preoperative rehabilitation compared with usual care in total knee arthroplasty: a meta-analysis of randomized controlled trials. Arch Phys Med Rehabil. 2026;107(2):315-332. doi:10.1016/j.apmr.2025.08.022
  31. Buhagiar MA, et al. Effect of inpatient rehabilitation vs a monitored home-based program on mobility in patients with total knee arthroplasty: the HIHO randomized clinical trial. JAMA. 2017;317(10):1037-1046. doi:10.1001/jama.2017.1224
  32. Florez-García M, et al. Efficacy and safety of home-based exercises versus individualized supervised outpatient physical therapy programs after total knee arthroplasty: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(11):3340-3353. doi:10.1007/s00167-016-4231-x
  33. Hartman J, et al. Braking time following total knee arthroplasty: a systematic review. J Arthroplasty. 2018;33(1):284-290.e1. doi:10.1016/j.arth.2017.08.012
  34. Pasqualini I, et al. Return to sports and return to work after total knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2023;11(7):e22.00250. doi:10.2106/JBJS.RVW.22.00250
  35. Finkelstein A, et al. Mandatory Medicare bundled payment program for lower extremity joint replacement and discharge to institutional postacute care: interim analysis of the first year of a 5-year randomized trial. JAMA. 2018;320(9):892-900. doi:10.1001/jama.2018.12346
  36. Haas DA, et al. Evaluation of economic and clinical outcomes under Centers for Medicare & Medicaid Services mandatory bundled payments for joint replacements. JAMA Intern Med. 2019;179(7):924-931. doi:10.1001/jamainternmed.2019.0480
  37. Navathe AS, et al. Cost of joint replacement using bundled payment models. JAMA Intern Med. 2017;177(2):214-222. doi:10.1001/jamainternmed.2016.8263
  38. Onggo JR, et al. Greater risk of all-cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta-analysis and systematic review. ANZ J Surg. 2021;91(11):2308-2321. doi:10.1111/ans.17138
  39. Bedard NA, et al. Tobacco use and risk of wound complications and periprosthetic joint infection: a systematic review and meta-analysis of primary total joint arthroplasty procedures. J Arthroplasty. 2019;34(2):385-396.e4. doi:10.1016/j.arth.2018.09.089
  40. Gao H, et al. Factors associated with periprosthetic joint infection following total knee arthroplasty: an updated systematic review and meta-analysis. Arch Orthop Trauma Surg. 2026;146(1). doi:10.1007/s00402-026-06492-0
  41. Premkumar A, et al. Projected economic burden of periprosthetic joint infection of the hip and knee in the United States. J Arthroplasty. 2021;36(5):1484-1489.e3. doi:10.1016/j.arth.2020.12.005
  42. Shichman I, et al. Projections and epidemiology of revision hip and knee arthroplasty in the United States to 2040-2060. Arthroplast Today. 2023;21:101152. doi:10.1016/j.artd.2023.101152
  43. Sarrel K, et al. Understanding economic analysis and cost-effectiveness of CT scan-guided, 3-dimensional, robotic-arm assisted lower extremity arthroplasty: a systematic review. J Comp Eff Res. 2024;13(4):e230040. Industry co-author. doi:10.57264/cer-2023-0040
  44. Chawla H, et al. Annual revision rates of partial versus total knee arthroplasty: a comparative meta-analysis. Knee. 2017;24(2):179-190. doi:10.1016/j.knee.2016.11.006
  45. American Academy of Orthopaedic Surgeons, OrthoInfo. Total knee replacement. orthoinfo.org/treatment/total-knee-replacement
  46. Mayo Clinic. Knee replacement. mayoclinic.org/tests-procedures/knee-replacement
  47. Cleveland Clinic. Knee replacement (arthroplasty). my.clevelandclinic.org/health/treatments/8512-knee-replacement
  48. Johns Hopkins Medicine. Knee replacement surgery. hopkinsmedicine.org/health/treatment-tests-and-therapies/knee-replacement-surgery-procedure
  49. Hospital for Special Surgery. 6 things to know about recovery after knee replacement. hss.edu/health-library/move-better/knee-replacement-recovery
  50. MedlinePlus (US National Library of Medicine). Knee joint replacement. medlineplus.gov/ency/article/002974.htm
  51. Salman LA, et al. The efficacy of aspirin versus low-molecular-weight heparin for venous thromboembolism prophylaxis after knee and hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc. 2025;33(5):1605-1616. doi:10.1002/ksa.12456