Total Knee Replacement
Understanding the Procedure, Benefits, and What to Expect
Total Knee Replacement Surgery
Total knee replacement is a surgical treatment for advanced knee arthritis and other conditions that have caused significant joint damage, pain and loss of function.
For patients facing persistent knee pain or a prolonged public-system wait, private knee replacement can provide another pathway to orthopedic assessment and treatment.
Dr. John Antoniou provides private total knee replacement surgery in Montreal for appropriately selected patients from Quebec, elsewhere in Canada and internationally.
Private total knee replacement currently starts at $19,800 CAD.
The goal of surgery is to reduce pain, restore mobility and help patients return to a more active and independent lifestyle.
At a Glance
What Is Knee Arthritis?
In a healthy knee, the ends of the thigh bone and shin bone are covered by smooth cartilage that allows the joint surfaces to move against each other with minimal friction.
With arthritis, this cartilage progressively wears down. In more advanced disease, the protective joint surfaces may become severely damaged and the bones can begin to rub against each other.
This can lead to:
- Persistent knee pain
- Swelling and inflammation
- Stiffness
- Reduced range of motion
- Difficulty walking or climbing stairs
- Pain at rest or during the night
- Progressive deformity in more advanced cases
Osteoarthritis is the most common reason for knee replacement surgery. Other conditions, including rheumatoid arthritis, post-traumatic arthritis and certain joint deformities, can also cause severe knee damage.
What Is a Total Knee Replacement?
A total knee replacement, also known as total knee arthroplasty, replaces the damaged surfaces of the knee joint with an artificial prosthesis.
The basic components of a knee replacement include:
- Femoral component: A metal component fitted to the end of the femur, or thigh bone
- Tibial component: A metal base positioned on the upper surface of the tibia, or shin bone
- Polyethylene insert: A durable plastic bearing surface positioned between the metal components to allow smooth movement of the joint
The components are commonly manufactured from materials such as cobalt-chromium or titanium combined with medical-grade polyethylene.
Implant selection and fixation are determined according to the individual patient's anatomy, bone quality and surgical requirements.
When Is Total Knee Replacement Recommended?
The decision to proceed with knee replacement is based on the patient's symptoms, X-rays, level of function and response to previous treatment rather than on age alone.
Surgery may be considered when knee pain:
- Significantly interferes with walking or everyday activities
- Causes pain at rest or during the night
- Limits work, exercise or recreational activities
- Is associated with substantial stiffness or deformity
- No longer responds adequately to appropriate non-surgical treatment
Non-surgical treatment may include medication, physiotherapy, activity modification, weight management and injections when appropriate.
The purpose of an orthopedic consultation is to determine whether total knee replacement is appropriate, whether additional non-surgical treatment should be considered or whether another surgical option is more suitable.
Who Is a Candidate for Knee Replacement?
There is no fixed age at which a patient automatically becomes a candidate for knee replacement.
Important factors include:
- Severity of the arthritis or joint damage
- Degree of pain
- Loss of mobility and function
- Effect on quality of life
- Response to previous treatments
- Overall medical health
- Patient goals and expectations
Although knee replacement is commonly performed in patients over the age of 55, younger and older patients may also be appropriate candidates depending on their individual condition.
Private Knee Replacement in Montreal
Some patients choose private knee replacement because they are looking for a different access and scheduling pathway from the public health-care system.
Dr. Antoniou evaluates patients from Quebec and other Canadian provinces who are considering private knee replacement surgery in Montreal.
Canada's benchmark for a planned total knee replacement in the public system is surgery within 26 weeks, or 182 days, from the date the patient is considered ready to be treated. Actual wait times vary considerably between provinces, regions, hospitals and surgeons.
Patients can also review our updated article on Knee Replacement Surgery Wait Times in Canada by Province for more detailed information.
For patients concerned about how prolonged waiting may affect mobility and quality of life, our article The Hidden Cost of Waiting for Hip & Knee Replacement provides additional information.
How Much Does Private Knee Replacement Cost?
Starting price
The current program provides a coordinated private care pathway covering the surgical treatment and early postoperative care.
The exact surgical plan, services included and final cost are confirmed after the patient's medical history, imaging and individual requirements have been reviewed.
When comparing private knee replacement programs, patients should understand what is included in the quoted price, including:
- Surgeon fees
- Surgical facility fees
- Anesthesia
- Knee implant
- Postoperative care
- Initial physiotherapy
- Follow-up
What Happens During the Private Knee Replacement Process?
Consultation
The patient's symptoms, medical history, previous treatments and goals are reviewed.
Imaging Review
X-rays and any other relevant imaging are assessed to determine the severity and pattern of joint damage.
Treatment Recommendation
Dr. Antoniou determines whether knee replacement is appropriate or whether another treatment should be considered.
Preoperative Preparation
Any required medical testing and preoperative clearance are completed.
Surgery
The damaged joint surfaces are replaced with the appropriate knee prosthesis.
Early Rehabilitation
Walking and physiotherapy begin early following surgery, followed by an individualized rehabilitation program.
How Long Does It Take to Recover From Knee Replacement?
Recovery varies from one patient to another.
Age, overall health, preoperative strength, the condition of the knee and participation in rehabilitation can all influence recovery.
Dr. Antoniou's current postoperative pathway includes early mobilization and physiotherapy.
- Walking
- Getting in and out of bed or a chair
- Using stairs when appropriate
- Using a walker, crutches or cane safely
Every patient's recovery is different, and the individual instructions provided by Dr. Antoniou and the physiotherapy team should always take priority over generalized recovery timelines.
When Can I Return to Work?
The return-to-work timeline depends greatly on the type of work performed.
As a general guideline:
- Some patients with primarily desk-based work may return within approximately 2 to 4 weeks
- More physically demanding work may require approximately 6 to 8 weeks or longer
Pain control, mobility, commuting requirements and the physical demands of the job must all be considered.
When Can I Drive After Knee Replacement?
There is no single driving timeline that applies to every patient.
A patient should be able to:
- Enter and exit the vehicle safely
- Control the operated leg adequately
- Perform an emergency stop safely
- React normally to road conditions
- Drive without medications that impair alertness or reaction time
The operated side can also influence the timeline.
Some patients may be ready to drive within several weeks, while others require longer. Driving should resume only when it is safe based on the individual recovery.
Can I Fly After Knee Replacement?
Travel planning is particularly important for patients coming to Montreal from outside Quebec.
Air travel involves prolonged sitting and can increase the risk of blood clots during the early postoperative period.
Patients travelling for surgery should therefore discuss their return-flight plans with Dr. Antoniou's team before booking their travel.
The appropriate timing depends on the patient's medical condition, surgery, recovery and length of the planned flight.
Travelling to Montreal for Private Knee Replacement
Patients from Ontario, Alberta, British Columbia and other parts of Canada may be evaluated for private knee replacement surgery in Montreal.
For patients travelling from outside Quebec, the treatment pathway may include:
- Review of existing X-rays and medical information
- Orthopedic consultation
- Preoperative planning
- Coordination of travel dates
- Surgery in Montreal
- Early postoperative recovery
- Planning for physiotherapy after returning home
- Follow-up arrangements
Where appropriate and operationally available, some preliminary review of medical information or imaging may be completed before the patient travels to Montreal.
Patients should discuss travel timing, accommodation, postoperative transportation and rehabilitation arrangements with the clinic before finalizing travel plans.
How Should I Prepare for Knee Replacement?
Preparing physically and medically before surgery can help support the recovery process.
Patients may be advised to:
- Participate in a preoperative exercise or “pre-hab” program
- Stop smoking
- Work toward a healthier weight when medically appropriate
- Optimize blood glucose control when living with diabetes
- Maintain appropriate nutrition
- Reduce excessive alcohol consumption
- Prepare the home for the early recovery period
- Arrange transportation and family support when necessary
The clinical team will provide individualized preoperative instructions.
What Medications Need to Be Stopped Before Surgery?
Medication management must always be individualized.
Patients should not stop prescription medications on their own.
During the preoperative process, Dr. Antoniou and the medical team review medications and supplements that may affect bleeding, clotting or surgical risk.
These may include:
- Anticoagulants and other blood-thinning medications
- Fish oil or omega-3 supplements
- Certain herbal supplements, including ginseng, garlic and ginkgo
- Hormone replacement therapy and oral contraceptives
- Certain immune-modulating medications
The timing of any medication interruption will be provided according to the individual patient's medical situation.
What Rehabilitation Is Available After Knee Replacement?
Physiotherapy begins early following surgery and plays an important role in restoring mobility, knee movement, strength and independence.
The current care pathway includes:
- On-site physiotherapy during the initial postoperative period
- Walking and mobility instruction before leaving the surgical centre
- Home physiotherapy referral through the local CLSC for eligible Quebec residents
- Coordination with a local physiotherapist for patients living outside Quebec or internationally
The rehabilitation program is adjusted according to the patient's progress.
What Are the Risks of Total Knee Replacement?
Total knee replacement is a well-established procedure, but all surgery involves potential risks.
Possible complications include:
- Infection
- Deep vein thrombosis or pulmonary embolism
- Stiffness or limited range of motion
- Persistent pain
- Nerve or blood-vessel injury
- Fracture
- Implant instability
- Wear or loosening of the prosthesis over time
- Possible revision surgery in the future
Individual risk depends on the patient's medical condition, anatomy and other health factors.
Dr. Antoniou reviews the relevant risks, benefits and alternatives with each patient before surgery.
What Activities Can I Do After Knee Replacement?
Many patients return to an active lifestyle following recovery.
Activities commonly performed after total knee replacement include:
- Walking and hiking
- Cycling
- Swimming
- Golf
- Recreational skiing
- Selected racquet sports
- Strength and fitness activities adapted to the replaced knee
Repetitive high-impact activities such as long-distance running and jumping are generally approached more cautiously because of the forces placed on the prosthetic joint.
Patients should discuss their individual sport and activity goals with Dr. Antoniou.
Why Choose Dr. John Antoniou for Knee Replacement?
Dr. John Antoniou, MD, PhD, FRCSC, FAAOS is an orthopedic surgeon specializing in hip and knee reconstruction and a Professor at McGill University.
His experience and credentials include:
- More than 15,000 joint procedures
- Fellowship training in hip and knee reconstruction
- Fellow of the Royal College of Physicians and Surgeons of Canada
- Fellow of the American Academy of Orthopaedic Surgeons
- Past President of the Canadian Orthopaedic Association
- Professor at McGill University
- More than 200 peer-reviewed publications
- Extensive experience in primary and complex hip and knee reconstruction
His private practice at Ortho Westmount provides consultation, surgery, postoperative care and early physiotherapy within a dedicated orthopedic setting in Montreal.
Frequently Asked Questions
How long do knee replacement implants last?
Modern knee replacements are designed for long-term use, but no implant has a guaranteed lifespan.
Longevity depends on factors including implant design, patient age, activity level, body weight, alignment and other individual considerations.
Many contemporary knee replacements continue to function well for 15 to 20 years or longer, and a substantial proportion last beyond this period.
Is knee replacement surgery painful?
Pain and swelling are expected after knee replacement, particularly during the early recovery period.
Pain-management strategies are used following surgery, and symptoms generally improve as healing and rehabilitation progress.
The long-term objective of surgery is to reduce the arthritic pain present before the operation.
Will I need physiotherapy?
Yes.
Physiotherapy is an important part of knee replacement recovery and helps restore knee movement, strength, walking ability and independence.
Will I be able to kneel after knee replacement?
Some patients can kneel after recovery, but others continue to experience discomfort or an unusual sensation when kneeling on the replaced knee.
The ability to kneel depends on healing, comfort, range of motion and individual factors.
When can I drive after knee replacement?
There is no single date that applies to everyone.
Patients should no longer be taking medications that impair driving and must have sufficient strength, mobility and reaction time to operate the vehicle safely.
Can I have private knee replacement if I live outside Quebec?
Yes.
Dr. Antoniou evaluates patients from across Canada, the United States and other countries.
For patients travelling to Montreal, the team can discuss imaging review, travel planning, postoperative care and physiotherapy arrangements.
Can both knees be replaced at the same time?
In selected patients, bilateral knee replacement may be considered.
It is not appropriate for everyone. Age, overall health, medical risk, severity of knee disease and recovery requirements must all be evaluated before simultaneous surgery is recommended.
What is the ideal age for knee replacement?
There is no fixed ideal age.
The decision is based primarily on the severity of joint damage, symptoms, functional limitations, response to previous treatment and overall health.
What type of anesthesia is used?
Dr. Antoniou typically performs knee replacement using spinal anesthesia with sedation when appropriate.
General anesthesia may also be used depending on the patient's medical situation, preference and anesthesiology assessment.
Will my knee replacement trigger airport metal detectors?
A joint replacement may be detected by airport security equipment.
Patients can inform security staff that they have an artificial joint. Screening procedures are determined by airport security authorities.
How long are public knee replacement wait times in Canada?
Canada's benchmark is surgery within 26 weeks after the patient is ready to be treated, although actual waits vary considerably between provinces and surgical programs.
Our updated Knee Replacement Surgery Wait Times in Canada by Province article provides more detailed current information.
How much does private knee replacement cost with Dr. Antoniou?
Private total knee replacement currently starts at $19,800 CAD.
The final treatment plan and cost are confirmed after the patient's medical information and imaging have been reviewed.
Considering Private Knee Replacement?
If knee pain is limiting your walking, sleep, work or daily activities despite appropriate non-surgical treatment, an orthopedic consultation can help determine whether total knee replacement is appropriate.
Dr. Antoniou evaluates patients from Montreal, elsewhere in Quebec, across Canada and internationally.
A consultation can help determine the appropriate treatment, review expected recovery and discuss current private surgery availability.
Request a ConsultationHave your case reviewed to determine whether total knee replacement is appropriate and discuss current private surgery availability.
Content updated: October 2026.