Prima Medical Group

Raymond Bonneau, M.D. Orthopedic Surgeon

165 Rowland Way, Suite 100
Novato, CA 94945
(415) 898-4211

Total Knee Replacement Information


You have been scheduled for a total knee replacement. This has now become a common procedure for people with severe osteoarthritis of the knee.

Pre-Operative Instructions

You should not take Motrin, Advil, Naprosyn, or any other nonsteroidal anti-inflammatories for ten days prior to surgery. You should not take aspirin for ten days prior to surgery unless you have had any type of cardiac surgery including angioplasty, stent placement or bypass then you will need to continue taking aspirin, unless otherwise instructed by your cardiologist. You may eat or drink anything you’d like the night before the surgery, but you should have no solid food after midnight the day of your surgery. You may have clear liquids up until 4 hours before your surgery but limited to 4 ounces. Clear liquids are fluids that light can shine through, such as apple juice, coffee, tea and water. This does not include orange juice or milk. The best thing to have is a glass of apple juice or cranberry juice approximately 6 hours before the surgery to give you some glucose and fluids to get by until the time of surgery. Please make sure you drink nothing, not even water, beginning 4 hours before surgery.

Going to the Hospital

You should report to Novato Community Hospital or Marin General Hospital 2 hours prior to the scheduled time of your surgery. If your surgery is in the afternoon, it is often a good idea to call Same Day Surgery 4 hours before your surgery to determine whether or not the surgical schedule is running on time. The number at Novato Hospital is (415) 209-1558. The number at Marin General is (415) 925-7557.

What to Wear

Loose clothing is best. It is a good idea to bring a pair of loose fitting sweat pants to wear when you begin physical therapy


You will get to speak to your anesthesiologist prior to the surgery. For knee replacements, you can have either a general anesthetic or a spinal anesthetic. On rare occasions, your medical condition may indicate that you have one or the other type of anesthesia, but for most patients, it’s simply a matter of choice depending on how you feel about it. You’ll be able to speak to the anesthesiologist and make a final decision before the surgery.


The procedure itself takes approximately two hours, although you’ll be in the operating room three hours. The extra hour is the time you’ll receive your anesthesia and time to put bandages on after the surgery. You’ll be in the recovery room for 1 to 2 hours and will be admitted to the hospital for 3 to 5 days.


Physical therapy will begin the first day after surgery. The physical therapist will visit you and you’ll begin to take a few steps and begin sitting up in a chair. The second postoperative day, you’ll begin ambulating with the therapist, using a walker or crutches. You’ll find you’ll be able to walk better and better each day. You’ll be able to put weight on your knee as tolerated.

Going home

Some patients are able to go directly from the hospital to their home after 3 to 5 days. Some patients require a week at a skilled nursing facility, such as Country Villa or Smith Ranch, prior to discharge. In either case, you’ll be able to go home when you can get up, get to the bathroom, get on and off the toilet, and get in and out of bed by yourself, so that you would be safe and independent at home. Discharge planning will take care of ordering the equipment you need and home physical therapy.

Postoperative Rehabilitation

Once at home, you’ll be on your walker or crutches for the first 3 weeks. During this time, you’ll be able to care for yourself at home, but your overall activities will be limited. The physical therapist will visit you at home to work on your range of motion exercises.

After 2 weeks, we’ll see you in the office, at which time you’ll be able to progress to a cane, begin driving a car and start returning to some of your normal day to day activities. You will also begin outpatient physical therapy at that time, meaning you’ll drive to the physical therapist’s office.

After 6 to 8 weeks, you’ll be off of a cane and be returning to most of your normal day to day activities. By 3 to 4 months, most patients can begin to play golf or take a vacation such as a cruise. By 6 months post-op, most people can walk a golf course or take a more vigorous vacation with hiking and other activities.