Total Knee Replacement

What to Expect

During total knee replacement surgery, Dr. Berger creates a small, 3- to 4-inch incision along the kneecap to reveal the end of the thigh bone, the top of the shin bone, and the back of the kneecap: the arthritic knee. While preserving the soft tissues, Dr. Berger begins by removing the arthritis on the bottom of the thigh bone, using special guides to help shape the bone so the prosthesis fits securely. He then removes arthritic bone from the top of the shin and the back of the kneecap. At this time any bone spurs or scar tissue that may have formed will be removed.

Next, Dr. Berger uses sizer pieces that range in increments of millimeters to measure the patient’s bone and determine the perfect-fit prosthesis. Upon reaching the optimal size, he secures the first part of the prosthesis to the end of the thigh bone using cement. The second part of the prosthesis is cemented to the top of the shin bone. He then snaps a polyethylene liner to the top of the shin bone component. This liner acts as cartilage and facilitates smooth and fluid movement. The final piece of the prosthesis is a polyethylene liner that is cemented to the back of the kneecap.

What Is Minimally Invasive Outpatient Total Knee Replacement?

A total knee replacement is a surgical procedure to replace the damaged surfaces of the knee joint with durable, artificial components. Dr. Richard Berger’s minimally invasive outpatient total knee replacement technique takes this procedure to the next level by offering patients a faster, less painful recovery—all without the need for an overnight hospital stay.

This innovative approach focuses on preserving healthy tissue and using smaller incisions, allowing patients to regain mobility and return home the same day.

Who Is a Candidate for Total Knee Replacement?

You may benefit from a total knee replacement if:

  • You experience severe pain that interferes with daily activities like walking, climbing stairs, or sleeping.
  • Your knee has been damaged by arthritis, injury, or wear and tear.
  • Non-surgical treatments like medications, physical therapy, or injections no longer provide relief.
  • You want to regain an active lifestyle and improve your quality of life.

Dr. Berger evaluates each patient individually to determine if minimally invasive total knee replacement is the best option.

Why Choose Dr. Berger’s Minimally Invasive Technique?

Dr. Berger’s total knee replacement method is designed to reduce pain and speed up recovery while delivering long-lasting results. Here’s how it stands apart:

  • Smaller Incisions: A shorter incision and precise surgical techniques minimize trauma to surrounding muscles and tissues.
  • Muscle-Sparing Approach: Key muscles and tendons are preserved, reducing post-surgical pain and swelling.
  • Quicker Recovery: Patients often walk unassisted within hours of surgery and return to normal activities in weeks rather than months.
  • Outpatient Surgery: Go home the same day to recover in the comfort of your own home, avoiding lengthy hospital stays.
  • Natural Feel & Function: Advanced implants and precise alignment result in a knee that feels stable and moves naturally.

Benefits of Outpatient Total Knee Replacement

Dr. Berger’s minimally invasive approach offers a range of benefits, including:

  • Less Pain: Advanced pain management techniques reduce discomfort during and after surgery.
  • Faster Mobility: Most patients are able to walk the same day and return to everyday activities sooner.
  • Convenience: Recover at home with personalized support from Dr. Berger’s team.
  • High Success Rates: Patients report significant improvement in pain, mobility, and quality of life.

Cancel any dental appointments that fall between 3 weeks prior to surgery and three months after surgery.

Avoid any injections into your surgical joint for 3 months prior to surgery.

In-home physical therapy

  • Dr. Berger’s patient services coordinator, DeAnna, will contact you prior to surgery to arrange your discharge plan. This includes services at your hotel as well as at your home, if applicable.
  • Home Health Services will be set up for three times a week for two weeks or until you are ready to progress into outpatient physical therapy.

Outpatient physical therapy

  • You are responsible for scheduling your outpatient physical therapy appointments.  Select an outpatient facility that is convenient for you and takes your insurance.
  • You will be given an outpatient physical therapy prescription from our office; a copy is also included in your spiral-bound book.
  • You will attend outpatient physical therapy three times a week for six weeks.

Goals to Achieve by 3 Weeks

  1. Bend your knee at least 110 degrees (flexion)
  2. Straighten the knee to 0 degrees (extension)
  3. Ambulate at least 2 blocks without an assistive device
  4. Independent with activities of daily living (i.e., showering, dressing, etc.)

Dr. Berger will prescribe post-operative medications for each patient after surgery. A multi-modal approach is utilized to adequately control pain and minimize risk factors after surgery for a desirable recovery and ideal outcome.

When you are ready for prescription refills, contact one of the nurses in the office during normal business hours (Monday through Friday, 7 am – 5 pm). Refills can be authorized to your local pharmacy. You will need to provide us with your local pharmacy’s phone number, the name of the medication you need to refill, and your birthdate.

WEEK 1:

RICE

R = Rest 
We want you to be up and moving, but do this in moderation. We recommend you rest for the first 5-7 days after surgery. DO NOT OVERDO IT. Increased activity means increased swelling. By decreasing swelling early, you will recover more quickly. We recommend small bouts of activity throughout the day. Get up and walk around the house every hour or so that you are awake.

I = Ice
Ice as much as possible for the first week to two weeks. Ice is a great anti-inflammatory and helps minimize swelling. You may apply an ice massage over the knee, the quadriceps muscle (located on the front of the thigh), the hamstring muscle (located on the back of the thigh), and the calf.

We will provide you with an ice machine on the day of your surgery.

C = Compress
The TED hose compression stockings provide compression and help minimize swelling. Keep the stockings on during the day and remove them at night for the first three weeks after your surgery. The stockings go on both legs.

E = Elevate
Elevating your leg will help reduce swelling. To reduce significant amounts of swelling, elevate your leg 4-5 times a day for 15-30 minutes each time. Lie flat with your ankle above your knee and your knee above your heart.

WEEK 2:

  • You may start using heat to help decrease bruising. Place a hot pack/heating pad over the front and back of the thigh (quadricep and hamstring muscles) and on the calf muscle. Try heat 3 times a day for 20 minutes each time. Using heat will increase your flexibility and make exercising easier. Alternate the heat and ice. Heat before you stretch/exercise, and use ice after activity.
  • Start outpatient physical therapy.
  • Focus on range of motion, exercises, and initiate strengthening to increase walking distance.
  • Return to driving.

WEEKS 3-6:

  • Ease into physical activity.
  • Continue outpatient physical therapy.
  • Return to work.
  • Significant reduction in swelling.

Real Patient Results