Total Knee Arthroplasty
(Knee Replacement Surgery)
Hip, Knee & Trauma · Johannesburg, South Africa
Knee pain slows you down. Knee replacement surgery is one of the most successful operations in orthopaedics, helping patients walk without pain again.
Walk Without Pain Again
Knee pain slows you down. Stairs hurt. Walking becomes hard work. Even a good night's sleep can be difficult. Knee replacement surgery (total knee arthroplasty or TKA) is one of the most successful operations in orthopaedics, with a success rate above 95 percent.
Dr Nabeel Moosa has performed hundreds of successful knee replacements. His patients in Johannesburg report dramatic pain relief, improved movement, and a return to the activities they love.
20+ Years of surgical experience
Patient satisfaction rate
95%
Years of implant lifespan
15 to 20+
What Is Knee Replacement Surgery?
Knee replacement removes the damaged surfaces of your knee joint. We resurface the end of the thighbone (femur) and the top of the shinbone (tibia), and often the back of the kneecap (patella). We replace them with metal components and a strong medical-grade plastic spacer. The new joint copies the smooth movement of a natural knee.
Modern knee replacements last 15 to 20+ years. Many patients never need revision surgery. Knee replacement is one of the most reliable procedures in orthopaedics, with success rates consistently above 95 percent.
Why Knee Replacement Works
- Relieves pain, including pain on stairs
- Restores movement and range of motion
- Corrects leg alignment (bow legs or knock knees)
- Improves sleep and quality of life
- Lasts 15 to 20+ years for most patients
Conditions Knee Replacement Treats
Osteoarthritis of the Knee
Osteoarthritis is the most common reason for knee replacement. The protective cartilage that cushions the ends of the bones gradually wears away. As cartilage deteriorates, bone rubs against bone. This causes pain, stiffness, swelling, and inflammation.
- Pain deep in the knee (worse with activity)
- Stiffness, especially in the morning or after sitting
- Difficulty with stairs, standing, or walking distances
- Swelling and a feeling of grinding or catching
- Bow-legged or knock-kneed appearance over time
Knee osteoarthritis develops over years. When conservative treatments no longer provide relief, knee replacement becomes the best treatment option.
Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. It causes inflammation of the joint lining, leading to pain, swelling, and eventually cartilage and bone damage. Both knees are often affected. Knee replacement may become necessary for patients with advanced RA who do not respond adequately to medications.
Post-Traumatic Arthritis
An old knee injury, a fracture, a torn ligament, or a cartilage tear can lead to arthritis years later. The joint surface never fully recovers, wears unevenly, and becomes painful. Knee replacement restores a smooth, stable joint.
Severe Deformity and Alignment Problems
- Bow legs (varus) that overload the inner knee
- Knock knees (valgus) that overload the outer knee
- Advanced arthritis in one or more compartments of the joint
When Dr Moosa Recommends Knee Replacement
Knee replacement is typically recommended when:
Conservative treatments have failed
You have tried physiotherapy, medications, weight management, activity modification, and possibly injections. Pain persists and interferes with daily life.
Imaging confirms significant damage
X-rays show advanced arthritis with narrowed joint space and bone touching bone in one or more compartments of the knee.
Pain significantly impacts quality of life
You have difficulty walking, climbing stairs, working, sleeping, or enjoying activities that are important to you.
You are ready and healthy enough for surgery
You have no serious medical conditions that would make surgery too risky, and you are ready to commit to physiotherapy after your operation.
Important note
Age alone is not a barrier to knee replacement. Patients in their 60s, 70s, 80s, and beyond can have successful knee replacements. Your general health and your motivation to participate in rehabilitation matter more than your age.
Ready for Pain-Free Movement?
Knee replacement surgery changes lives for most patients. If you are tired of knee pain limiting your activities, explore your options with Dr Nabeel Moosa. He will thoroughly evaluate your knee, discuss all your options, and help you determine if knee replacement is right for you.
The Evaluation Process
Initial Consultation with Dr Moosa
Your first visit is comprehensive. Dr Moosa will take time to understand your situation.
Medical history
When did your hip pain start? What makes it better or worse? What medical conditions do you have? What medications do you take? What are your goals for surgery?
Physical examination
Tests your hip range of motion, assesses pain with different movements, evaluates your overall mobility and gait, and checks for other joint problems.
Pre-Surgical Testing
Before surgery, you undergo:
Blood tests
Complete blood count, chemistry panel, clotting studies.
EKG and chest X-ray
Heart tracing, plus chest X-ray if needed based on age or medical history.
Anaesthesia consultation
Includes testing for infection if you have risk factors.
Pre-Operative Preparation
Weeks Before Surgery
Improve your physical condition
Exercise and walking strengthen your body. Surgery is less risky and recovery is faster if you are in better shape.
Manage your weight
If you are overweight, losing even a few kilograms reduces stress on your healing hip.
Review your medications
Dr Moosa will advise which medications to continue or adjust.
Stop smoking
Stopping before surgery dramatically improves healing. This is critical for your recovery.
Days Before Surgery
Stop eating and drinking
You will receive specific instructions (typically nothing after midnight).
Arrange transport
You cannot drive yourself home after anaesthesia.
Prepare your home for recovery
Place frequently used items at waist height to avoid bending after surgery.
Pack items for the hospital
Phone, medical aid card, list of medications, comfortable clothes.
Day of Surgery
- Arrive early (typically 2 to 3 hours before scheduled surgery time)
- Complete final paperwork and sign consent forms
- Change into hospital gown
- Have an IV placed
- Meet with your anaesthetist
- Say goodbye to your support person and head to surgery
The Surgical Procedure
Anaesthesia
We ensure you are pain-free during surgery. Many knee replacements use spinal or regional anaesthesia (numbing the lower half of your body while you are sedated), and general anaesthesia is also used. Dr Moosa and the anaesthesia team choose the best approach for your situation.
Implant Types and Longevity
Total knee replacement
Resurfaces all worn compartments of the knee — the most common procedure.
Partial (unicompartmental) knee replacement
Resurfaces only the damaged part of the knee when arthritis is limited to one compartment. Smaller incision and faster recovery for suitable patients.
Cemented and uncemented fixation
Bone cement gives immediate fixation; uncemented components let bone grow into a porous surface. Expected longevity: 15 to 20+ years for most patients. Many last 25 to 30+ years.
The Operative Steps
Step 1 — Incision
Made over the front of the knee (smaller for minimally invasive approaches).
Step 2 — Exposure
The kneecap is gently moved aside to expose the joint surfaces.
Step 3 — Remove damaged surfaces
The worn ends of the thighbone and shinbone are precisely trimmed.
Step 4 — Prepare the bone
The bone is shaped to accept the implant components accurately.
Step 5 — Fit the femoral and tibial components
Metal components are fixed to the thighbone and shinbone.
Step 6 — Insert the spacer
A durable medical-grade plastic spacer sits between the metal parts to glide smoothly.
Step 7 — Balance and test the knee
Dr Moosa checks the alignment, stability, and balance through a full range of motion.
Step 8 — Close the incision
Tissues are sewn back together and the incision is closed.
Operative time: usually 1 to 2 hours, depending on complexity.
Results You Can Expect
Pain relief
Dramatic or complete pain relief within 3 to 6 months, including relief from the stair and night-time pain that arthritis causes.
Functional improvement
Normal walking and stairs by 8 to 12 weeks, better leg alignment, and an easy return to getting in and out of chairs and cars.
Longevity and revision surgery
Most knee replacements last 15 to 20+ years or longer. At 10 years, approximately 90 to 95 percent are still working well. Lifespan depends on your age and activity level, body weight, bone quality, the implant chosen, and proper rehabilitation. If revision becomes necessary, modern techniques allow for successful revision surgery.
Ongoing Activity
Recommended activities
- Walking
- Swimming and water aerobics
- Cycling
- Golf
- Bowls
- Gardening
- Low-impact fitness classes
- Travel
Activities to avoid or modify
- Running and jogging
- Jumping and contact sports
- Deep repeated squatting or kneeling under load
- Extreme high-impact activities
Ready for Pain-Free Movement?
Knee replacement surgery changes lives for most patients. If you are tired of knee pain limiting your activities, explore your options with Dr Nabeel Moosa. He will thoroughly evaluate your knee, discuss all your options, and help you determine if knee replacement is right for you.