Do I need a knee replacement?
A total knee replacement caps the worn ends of the knee with metal and medical-grade plastic to relieve bone-on-bone arthritis pain that no longer responds to other treatment. The American Academy of Orthopaedic Surgeons puts nonsurgical care first (AAOS Knee OA Guideline, 2022), and some patients who ask us this question hear "not yet."
The path most knees take
- Symptoms
Pain gets louder
Aching after activity becomes aching at rest, then at night. Stairs and kneeling hurt.
- Diagnosis
A standing X-ray
"Bone-on-bone" means the cartilage is gone in at least one part of the joint.
- First moves
Everything short of surgery
Activity changes, in-house physical therapy, anti-inflammatories and injections. These buy some knees years.
- The line
When surgery makes sense
Pain that interrupts sleep, a shrinking life despite conservative care, bone-on-bone imaging, and a patient who is ready. When is the right time?
- The surgery
One to two hours
(Mayo Clinic.) With robotic assistance, a CT scan builds a 3D plan and the robot helps your surgeon place the implant to it.
- Recovery
Walking day one
Steps the day of surgery, then therapy with our own team on the same campus. Week-by-week summary below.
Who performs knee replacement at Sterling Ridge
Three fellowship-trained orthopedic surgeons replace knees at Sterling Ridge Orthopaedics & Sports Medicine, one of the leading joint replacement practices in the Houston area.
- Paul C. Chin, MD, PhD, FAAOS, FAANA: fellowship-trained in sports medicine, Mako certified. Robotic and partial knee replacement, shoulder replacement and hip arthroscopy. First surgeon in Texas to use the Medacta NextAR augmented-reality shoulder platform.
- N. Brian Flowers, MD, MPT, FAAOS: fellowship-trained at Hospital for Special Surgery, former physical therapist, Mako certified, Fellow of the American Association of Hip and Knee Surgeons. Primary hip and knee replacement.
- Rohan A. Gheewala, MD: adult reconstruction fellowship, Baylor College of Medicine. Primary, complex and revision hip and knee replacement, and second opinions.
Qualified patients have surgery at the Sterling Ridge / Woodforest Ambulatory Surgical Center, built with Memorial Hermann in Montgomery, with three operating rooms and physical and aquatic therapy on the same campus. Our surgeons also hold privileges at several area hospitals when your insurance or health history calls for a hospital stay. Consults are at The Woodlands, Spring and Woodforest, Monday through Friday, 8:00 AM to 5:00 PM. No referral needed.
Partial or total knee replacement?
The knee has three compartments. If arthritis has worn only one, usually the inside, a partial knee replacement resurfaces just that compartment, keeps your ligaments, and means a smaller incision and a quicker early recovery. If two or three are worn, you need a total knee, which also lasts longer. Dr. Chin performs partial knees here.
Robotic-assisted knee replacement
Dr. Chin and Dr. Flowers both perform it. A CT scan builds a plan before surgery, and in the operating room the robotic arm holds the cutting tools to that plan. Robots were used in 15.9% of U.S. total knee replacements in the latest registry report (AJRR, 2024). The robot makes placement more consistent; the surgeon's judgment still decides your result. How robotic surgery works.
Same-day knee replacement at our surgery center
Most healthy patients go home the day of surgery. Medicare removed total knee replacement from its inpatient-only list in 2018 (AAHKS), and the average U.S. hospital stay fell from 2.9 days in 2012 to 1.1 days in 2023 (AJRR, 2024). A review of 41 studies found no difference in complications, readmissions or outcomes between outpatient and inpatient joint replacement (Bemelmans et al., 2022). Your surgeon picks the setting with you based on your other medical conditions, support at home and the surgery itself. Is outpatient joint replacement safe?
Knee Replacement Care at Sterling Ridge
Your surgeon will explain your treatment options, the proposed procedure and the next steps in your care. If surgery is recommended, your care team will discuss the surgical location and rehabilitation plan with you.
What does it cost?
National Medicare averages, facility charges only: a hospital inpatient hip or knee replacement (DRG 470) carried an average hospital charge of $93,184 in 2024, against an average Medicare payment of $14,322 (CMS Medicare Inpatient Hospitals, 2024). As a hospital outpatient procedure, the Medicare allowed amount for a total knee replacement (CPT 27447) averaged $12,381, with Medicare paying $10,750 (CMS Medicare Outpatient Hospitals, 2024). Surgeon and anesthesia fees are separate, and commercial plans differ. We are in-network with Aetna, Blue Cross Blue Shield, Cigna, Medicare and United Healthcare, and you get a written estimate before you decide. Cost and insurance.
A surgeon who had it done
Our own Dr. Bill Hayes had a knee replacement here, filmed it, and rehabbed with the team that will rehab you. His video is below.
How long will it last?
Usually decades. In a registry study of 299,291 knee replacements, about 82% of total knees were still in place at 25 years, versus about 70% of partial knees (Evans et al., 2019). The American Joint Replacement Registry, drawing on 3.7 million U.S. cases, reports a revision rate of 0.83% at one year and 2.60% at ten years (AJRR, 2024), and the AAOS patient guide puts more than 90% still working at 15 years (OrthoInfo). Individual results vary. What shortens or extends implant life.
Recovery, in brief
- Day 0–1
Up and moving
Most patients take steps the day of surgery. Many go home that day.
- Weeks 1–2
Protect and activate
Home exercises, swelling control, first therapy visits.
- Weeks 3–6
Range, strength, car keys
Most daily activities return (OrthoInfo), and most patients drive again around week 4.
- Months 2–3
Back to work
Across 44 studies, the average return to work was 12.9 weeks, and 90% of patients were back within a year (Pasqualini et al., 2023).
- Month 6+
Back to sport
82% of patients return to sport, mostly low-impact, at an average of about 20 weeks (Pasqualini et al., 2023). Mild swelling can linger 3 to 6 months.
The full week-by-week recovery timeline.
Common questions
When can I drive again?
Around four weeks for most patients. Braking reaction time returns to normal between one and eight weeks after surgery (Na et al., 2020). You must be off narcotic pain medicine and able to brake hard without hesitating. Full answer →
Is robotic knee replacement better?
It is more precise, but not proven to feel better. A review of 12 randomized trials found robotic assistance cut alignment outliers by about 57% but showed no meaningful difference in function, range of motion, revision or complications versus a skilled surgeon's manual technique (Ruangsomboon et al., 2023).
Do I have to stay in a hospital?
Not necessarily. The hip and knee surgeon societies' joint position is that outpatient joint replacement is safe and effective for properly selected patients (AAHKS, 2024). Qualified patients have surgery at our surgery center and sleep in their own bed that night. If a hospital stay is safer for you, we will say so.
What if I've already had a replacement that's failing?
Revision surgery is its own specialty. Dr. Rohan Gheewala, fellowship-trained in adult reconstruction at Baylor College of Medicine, handles complex and revision hip and knee cases here. Bring your records. About revision surgery →
Dr. Flowers replaced my knee today. Everything was flawless from beginning to end.— Chris Ryman · Google review · knee replacement
Patients come from Conroe and Lake Conroe, Willis, Magnolia, The Woodlands and Spring.
The surgeons who replace knees here
Read each profile for training, areas of care and office locations.
Paul C. Chin, MD, PhD, FAAOS, FAANA
Brian Flowers, MD, FAAOS
Rohan Gheewala, MDSources
- American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Nonarthroplasty), Clinical Practice Guideline, 2021/2022.
- Evans JT et al. How long does a knee replacement last? Lancet, 2019.
- American Joint Replacement Registry. 2024 Annual Report highlights.
- Ruangsomboon P et al. Robotic-assisted versus conventional total knee arthroplasty: meta-analysis of randomized trials, 2023.
- AAHKS, Hip Society, Knee Society, AAOS. Position Statement on Outpatient Joint Replacement, 2024.
- Bemelmans YFL et al. Safety and efficacy of outpatient hip and knee arthroplasty: systematic review, 2022.
- AAHKS. Removal of TKA from the Medicare inpatient-only list, 2018.
- CMS. Medicare Inpatient Hospitals by Geography and Service, 2024 (DRG 470).
- CMS. Medicare Outpatient Hospitals by Geography and Service, 2024 (CPT 27447).
- AAOS OrthoInfo. Total Knee Replacement.
- Na A et al. Brake reaction time after total knee arthroplasty, 2020.
- Pasqualini I et al. Return to work and sport after total knee arthroplasty: systematic review, 2023.
- Mayo Clinic. Knee replacement.
Medically reviewed by Keith W.V. Johnson, MD, FAAOS · Updated October 21, 2026