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Total Knee Replacement Surgery

Total Knee Replacement Surgery – Severe arthritis of the knee causing significant life altering pain or poor function is the main reason to have your knee replaced with a metal/polyethylene prosthetic. Knee replacement surgery is considered elective, meaning you can live without the surgery. Therefore you must understand all of the significant risks and benefits before opting for surgery.

You should have exhausted all non-operative, conservative approaches such as physical therapy to strengthen the joint, oral non-steroidal anti-inflammatory medications, weight loss, using a cane or walker injected anti-inflammatory or cartilage building medications. Despite recent advances in technology, the typical prosthetic knee lasts only 10-20 years, so it is favorable to delay the surgery with non-operative interventions for as long as possible. Reoperation is difficult and carries a higher complication rate.

If you are considering total knee replacement surgery make sure you first consult with an experienced orthopedic surgeon in your area. There are many diseases of the knee, which may cause pain or functional problems that DO NOT require total knee replacement surgery. You may benefit from a lesser procedure such as arthroscopy (using a scope to examine the knee) to remove or repair damaged cartilage. There are also other procedures that may be better alternatives in younger patients such as osteotomy, microfracture or osteochondral allograft transfer (OATS). Discuss your options with an orthopedic surgeon.

If it does end up that an orthopedic surgeon in your area agrees that your best option is to have the knee replaced, you may consider having your total knee replacement surgery done in Mexico by a qualified, well-trained, board certified orthopedic surgeon.

Many people do not have adequate insurance and you can usually save $20,000- $30,000 with MedToGo. To ensure your safety and to optimize outcome, you will have to follow certain guidelines. MedToGo will be there to ensure that you are informed at every step of the way.


By choosing to have your total knee replacement surgery done in Mexico, you will have to organize your own preoperative evaluation and post-operative rehabilitation. Our goal at MedToGo is to inform you of the medical reasons for knee replacement, the steps you should take to insure that you are fit for surgery and the potential complications you must consider.

We will then provide you with guidelines for your rehabilitation and what to expect. We recommend that you work in conjunction with your primary care provider to facilitate the process. First consider the INDICATIONS FOR SURGERY:

1. Severe Pain
2. Significant loss of function
3. Severe arthritis (rheumatoid or osteo)
4. Osteonecrosis (dead bone) of the knee
5. Tumors of the knee

If you have documentation of any one of these conditions, you may be a good candidate for total knee replacement surgery. Next, you must provide documentation from your local physicians that you are a good surgical candidate and that you do not have any contraindications to surgery.

CONTRAINDICATIONS (reasons why you cannot have the surgery) include:

1. Active infection in the knee or anywhere else in the body
2. Poor extremity circulation
3. Neurologic disease affecting the extremity
4. Faulty extensor mechanism (i.e you have ligament and/or muscle disease or conditions that do not allow you to straighten your leg)

A thorough PREOPERATIVE EVALUATION must be performed on every patient prior to total knee replacement surgery, which includes:

1. Complete history and physical
2. Chest X-ray
3. Laboratory workup (PT/INR, CBC, CMP, UA)
4. 12-lead EKG (electrocardiogram)

If the preoperative evaluation finds that there is an increased risk from any health condition, referral to and clearance from the appropriate specialist is mandatory.

Also, you should review treatment alternatives (conservative non-operative interventions vs operative non-knee replacement surgery), and discuss the risks and benefits with an appropriate medical professional.

COMPLICATIONS of total knee replacement surgery include:

1) Anesthetic allergies or reactions to anesthesia
2) Thromboembolism or deep venous thrombosis (blood clots that develop in the leg or arm): Potential, and sometimes lethal complications
3) Infections: Uncommon, but potentially serious. Prosthetic joint infection may result in prolonged hospitalization and even a need for removal of the infected prosthesis, followed by reimplantation of a second prosthesis.
4) Nerve injuries or arterial injuries (rare)
5) Periprosthetic fracture: A fracture to the bone that holds the metal implants.
6) Wound dehiscence: stitched wound falls apart and opens up
7) Polyethylene and metal wear: May lead to loosening of the prosthesis, and a revision might be necessary.

The ultimate success of the procedure will depend tremendously on your participation in a qualified postoperative physical therapy program. Increased range of motion, decreased pain, and improved quality of life can be determined by the amount of physical therapy and rehabilitation performed by the patient.


Non-steroidal anti-inflammatory medications should be stopped 7 days prior to surgery. Warfarin (Coumadin) should be stopped 3-5 days prior to surgery (consult with your local doctor to determine if stopping Warfarin is safe).


Immediately after total knee replacement surgery you will receive low dose blood thinners to prevent dangerous blood clots that can form in the legs. You will stay in the hospital for 3-5 days. You will begin your rehabilitative exercises, which will focus on range of motion, normal walking mechanics and thigh muscle strengthening.

After total knee replacement surgery you can expect to return to near normal activities of daily living in approximately three to six weeks. Still you should avoid running, jogging or high impact sports. The more active you are with the prosthetic knee, the faster it will wear out.

Cycling, swimming and walking are encouraged. Some people prefer to have their entire post operative rehabilitation completed in Mexico where it is very inexpensive when compared to the equivalent in the US. Please ask your health care coordinator if this is an option you would like to explore.

To hear about the experiences of MedToGo International clients who have undergone Total Knee Replacement Surgery, please visit our testimonials page.

Testimonial » view all

My name is Mark Sawko, I am from Chandler, Arizona. I am 55 years old and I had a knee replacement surgery in Puerto Vallarta, Mexico done by Dr. Max Greig. My knee is in terrific shape, no complaints the surgery was very successful, I am able to do many things including golf and yoga and all kinds of different sports, so I feel it was very successful. I found out about MedToGo because it was owned by one of my friends Dr. Robert Page and his family Dr.

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Mark Sawko - Total Knee Replacement Testimonial