Dr. Yudi Kerbel, MD, Philadelphia, PA (2026)

08/27/2026

A new study found something that sounds backwards.

The knee replacement patients who expected the most were often the ones who ended up most disappointed. Even when their surgery actually went perfectly.

Researchers asked patients what they expected their recovery to look like, then checked a year later to see how they actually did. Most people expected improvements bigger than a knee replacement can realistically deliver. And the bigger the gap between what they expected and what they got, the more likely they were to be unhappy.

Now before you panic, in that same study the large majority of patients were STILL SATISFIED with their result.

I want to be very clear about something here. I am not telling you to expect a bad outcome or to lower your hopes. I talk all the time about going into surgery expecting to do well, and I stand by that completely.

What I AM saying is that you have to understand what a knee replacement actually is. It's metal and plastic. It's very good, but it's not perfect. It's not the knee you had when you were 18, and it never will be.

Within that understanding, expect the best. Expect to dramatically lower your pain. Expect to have better stability and mechanics in your knee. Expect to get your life back and get back to doing the things that you love.

But if you're expecting to wake up with a brand-new knee like you had when you were 18 years old, you're going to be disappointed no matter how well the operation goes.

The patients who do best are the ones who know exactly what they're signing up for. Aim high, just aim at the right target.

What were you expecting your recovery to be like, and how did it actually go? Let me know in the comments.

If you want to hear more evidence-based insights to help you get a better outcome after your knee or hip replacement, sign up for my weekly joint health newsletter. Visit www.drkerbel.kit.com to join for free.

Study: Selph et al. "Patient Expectations for Patient-reported Outcomes After Total Knee Arthroplasty Surpass Actual Outcomes and Correlate With Dissatisfaction." Arthroplasty Today, 2026.

08/26/2026

The biggest argument against partial knee replacements just got a lot weaker.

The American Joint Replacement Registry published the largest analysis ever done on partial knee replacements in the US, covering 101,468 cases from 2012 to 2024.

At 12 years, both total and partial knees had survivorship in the mid 90s. About 95% of partials still in place, versus about 96% of totals. So yes, partials are revised slightly more often than total knees, but not by much. The difference is far closer than most patients are told, and far closer than most surgeons assume.

And there's another factor here that nobody talks about.

Surgeons doing more than 35 partials a year had a revision rate of 4.4% at 12 years, while surgeons doing fewer than 15 a year were at 6.6%. The report shows that 93% of surgeons do fewer than 15 partials a year, putting them in that higher revision risk bracket.

So durability doesn't really depend on the implant. It depends on the surgeon putting it in. Go to someone who does more of them and it lasts longer.

For the right patient, a partial means a smaller operation, more of your own knee left intact, your ACL preserved, and usually a much easier recovery. If one part of your engine breaks, you don't throw out the engine. You replace the broken piece.

My honest estimate is that 30 to 40% of people getting a total knee could be candidates for a partial instead. Not everybody qualifies. The arthritis has to be confined to one compartment and your ligaments need to be intact.

So if you think you're a candidate, ask your surgeon whether you meet the criteria and how many partials they do a year. If it's only a handful, ask for a referral to someone in your area who does a high volume of them.

And if you want more evidence based straight answers about knee and hip arthritis, join my free weekly joint health newsletter. Visit www.drkerbel.kit.com to sign up for free.

08/25/2026

Everyone braces for the pain after a knee replacement. Almost nobody plans for what it does to their sleep.

Your sleep takes a real hit, especially in the first 2 to 6 weeks, and then settles back to normal by about 3 months. If you find yourself staring at the ceiling unable to sleep after your knee replacement, just know that you're not alone.

What most people don't realize is that sleep and pain feed each other. Pain wrecks your sleep, and then poor sleep turns around and amplifies your pain.

I've spent years researching every way I can find to make sleep better after knee replacement. One of the most interesting things I found is that one normal sleep hack actually backfires after this surgery...

Sleep trackers. Normally, if you're working on your sleep, you check your sleep data and let it help you get better. But in one interesting study of people with insomnia, researchers found the tracker just made things worse.

They gave patients fake feedback from a sleep tracker. Some were told they'd slept badly, some were told they'd slept well, but the data was just made up.

The ones who were told they'd slept badly were more tired and had worse cognition the whole next day, even though their sleep was actually the same and the numbers on their wrist were fake.

Now this doesn't mean that your tracker is the enemy. In normal circumstances it can be a valuable tool. But if you're struggling with sleep after your knee replacement and it's causing you anxiety, the numbers on that tracker might just be making things worse.

My advice is that in the first weeks after your knee replacement, ditch the tracker and just focus on how you feel. Once your rest gets back on track and you're feeling like yourself again, feel free to get back to your normal tracking.

And if you found this helpful and want to know all the tips and tricks I found after looking through every single article ever published on sleep after knee replacement, visit:

www.stan.store/drkerbel

To get my book on getting your sleep back after surgery.

Study: Gavriloff et al. "Sham sleep feedback delivered via actigraphy biases daytime symptom reports in people with insomnia." J Sleep Res, 2018.

08/25/2026

You've been told you can't kneel after your knee replacement. That's simply not true.

And it bothers me, because I see people giving up things they love, like gardening or playing on the floor with their grandkids or praying, when actually they could be back doing all of those things.

Most people can kneel again. They just need a simple progression that nobody ever teaches them.

Let's start with the fear, because that's what really stops people. You are NOT going to damage anything by kneeling on a replaced knee. The implant is fixed solidly to your bone, and there is no clinical reason you can't kneel on it. That part is settled.

What's actually stopping you is the strange way kneeling feels after a knee replacement. And there's a reason for that. When we do the surgery, we cut a small skin nerve that runs across the front of your knee, so the outside of it ends up numb. It's never going to feel exactly like it did before. But you can get used to that, and you can learn how to kneel on it again.

There's a study out of Rush, which is where I did my fellowship, that looked at patients a year or two out from their surgery. Most of them could already kneel with little or no difficulty, with no special training at all. And out of the ones who couldn't, most were able to get there once they went through a simple kneeling progression.

So it's not that your knee can't do it. It's that nobody showed you how.

It takes a few weeks, and it's super simple once you know it.

So let me show you. Visit:
bit.ly/kneelvideo and I'll send you the video where I take you through it step by step.

Study: Wallace and Berger. "Most Patients Can Kneel After Total Knee Arthroplasty." Journal of Arthroplasty, 2019

08/23/2026

In a lot of knee arthritis, only one part of the knee is actually worn out.

So why would we replace the whole joint?

When the damage sits in one compartment only (which in some studies is ~1/3 to 1/2 of knee arthritis patients), a partial knee replacement is a great option that you should at least discuss with your surgeon.

In a partial knee, we resurface the worn part only. Your ACL and natural alignment stay that way, and the knee feels more normal. Several studies show that patients with a partial are more likely to forget they ever had surgery than patients with a total. In other words, it feels more like your own natural knee, instead of the artificial feeling that some people have after a total.

Recovery is faster, and risks are lower. Across 100,000 matched patients, registry data shows fewer blood clots, fewer heart complications, even fewer deaths.

But what about the objection that everyone raises...don’t partials fail sooner?

Registries do show that they get revised more often, but those numbers are misleading, and here’s why...

First, a partial depends on the surgeon far more than a total does. Surgeons who do a lot of them get far better results than surgeons who only do a handful a year, and most surgeons fall into that second group. In the largest registry study, the high-volume partial knee surgeons had revision rates very close to total knee. This is why it’s so important to find a surgeon who does a lot of partial knee replacements if you’re going to go that route.

Second, a partial is easy to revise to a total, but a total is much harder to redo. Many surgeons pull the trigger much quicker to revise a partial than they ever would for a total. The numbers are skewed because there’s a bias among surgeons to revise a partial more than a total.

So if you’re considering surgery, ask whether you’re a candidate for a partial before you agree to replace all of it. Then ask your surgeon how many partials they do a year.

If you want to hear more evidence-based insights that will help you get a better outcome after your knee or hip replacement, sign up for my weekly joint health newsletter. Comment NEWSLETTER and I’ll send you th

08/22/2026

The hardest part of knee replacement isn’t the pain. It’s where your mind goes when the pain goes away…and then COMES BACK.

You’ve strung together a few good days. You’re finally starting to feel hopeful. And then out of nowhere your knee is throbbing again, and your mind goes straight to the dark place:

Did I damage something?
Is it infected?
Did I ruin the whole thing?

I want you to hear this from the person who does these operations for a living:

That moment is completely NORMAL, and EVERYONE who goes through this recovery has the exact same thing happen to them.

Recovery isn’t a straight upward line. You do a little too much one day and the knee lets you know about it the next. A good week gets interrupted by a rough morning. None of that means something has gone wrong. It’s just the natural pattern of healing from this surgery, and it catches everyone off guard because nobody describes it honestly beforehand.

You can brace yourself for the physical pain, but it’s that mental spiral that quietly takes you down, because you think you’re the only one it’s happening to.

So let me just reassure you. You’re not.

And the next time it hits, take a breath and remind yourself of this video.

You’re gonna be okay.

If you’ve been through recovery, what was the thought that went through your head when the pain came back? Drop it below. It might be the thing that helps someone still in it feel less alone.

08/21/2026

Everyone assumes that going to an inpatient rehab facility after a knee replacement is the safer choice.

The data says otherwise.

In large studies, the people who went straight home had fewer complications and fewer readmissions than the ones sent to a facility. And it had nothing to do with how sick the patients were, because they made sure both groups had the same characteristics.

Another study found that the patients who went to a rehab facility had nearly double the rate of complications.

The studies show that not only is inpatient rehab linked to more problems, but going home the same day is perfectly safe for most people. In a study of over half a million joint replacements, patients who went home the same day were no more likely to be readmitted than the ones who stayed in the hospital.

Now, I’m not saying that all rehab facilities are bad. Like anything else, there are good rehabs and bad rehabs, and some people genuinely do need to go to a facility after their surgery because of their social situation, deconditioning, or their overall health. For those patients, going to rehab is the right call, and I still do send some patients there myself.

But for most people, home is where you can sleep better, move on your own terms, and not be around all of the microbes that live in healthcare facilities.

Don’t assume that going to a rehab facility after surgery is the safer choice. Ask your surgeon if you’re a candidate to go straight home and start planning for it before your surgery.

And if you want to hear more evidence-based insights to help you get a better outcome after your joint replacement, sign up for my weekly joint health newsletter. Comment NEWSLETTER and I’ll send you the sign-up link.

Studies: Owens et al. “Short-term Morbidity and Readmissions Increase With Skilled Nursing Facility Discharge After Total Joint Arthroplasty.” Journal of Arthroplasty, 2018.
Lan et al. “Contemporary Outpatient Arthroplasty Is Safe Compared with Inpatient Surgery.” JBJS, 2021.

08/20/2026

I can tell you exactly which part of your knee went numb after your knee replacement…And why you can stop worrying about it.

It happens because we cut your nerve. We do it in every single knee replacement, and it’s completely normal.

Let me explain.

To get into the knee, we make an incision down the front. Running straight across that path is a small sensory nerve called the infrapatellar branch of the saphenous nerve.

That nerve is purely a sensory nerve. It doesn’t control any muscle and it doesn’t move anything. All it does is supply feeling to the front and outer part of your knee. And it sits directly in the path of our incision, so the tips of it always get cut.

So afterwards you get a patch of numbness on the outside of your knee, just past the scar.

In some people the feeling gradually comes back over months. In others it stays numb permanently. Either way, it has no effect on how your knee works, and it’s nothing to worry about.

Patients bring this up with me all the time. You might notice it when you’re shaving, or when you kneel down. But it doesn’t change what your knee can do, and it doesn’t mean anything went wrong.

So if part of your knee feels numb after your knee replacement, just know this:

1. It’s totally normal
2. It’s nothing to worry about
3. Now you know exactly why it’s happening…So you can stop worrying about it!

And if you want more evidence-based insights to help you get a better outcome after your knee or hip replacement, sign up for my weekly joint health newsletter. Comment NEWSLETTER and I’ll send you the sign-up link.

08/19/2026

Most people are told they’ll need weeks of heavy narcotics after a knee replacement. But that hasn’t been true for a while now.

Pain control after joint replacement has changed more in the last 5 years than in the 20 before it. And some of the newest thinking is the exact OPPOSITE of what you’ve been told.

Let’s start with the strangest one. The evidence now points toward doing LESS after surgery, not more. LIMIT your walking. REST more. Let the swelling settle instead of pushing through it. The old no pain, no gain framework was making people hurt more, not recover faster.

Then there’s what happens in the operating room. Personalized alignment and quad-sparing approaches can both lower the pain you feel after surgery and make the early portion of your recovery easier.

And there’s a new class of medication called NaV1.8 inhibitors. I’ve been using them on my patients for the last year and the results have been incredible.

None of these is the answer on its own, but layered together they work remarkably well, and can dramatically lower your need for narcotics.

Because despite what you’ve been told, the goal is to limit narcotics during your recovery. They cause grogginess, nausea, constipation and a risk of dependence, which are all added problems we don’t want stacked on top of your recovery. With a modern plan they should be a minimal part of your medication, not the center of it.

So if you’re thinking of getting a knee replacement, make sure to find a surgeon who uses a modern pain control program that gets you through your recovery without the need to be knocked out on harmful narcotic medications.

And if you want more advice on how to get a better outcome after knee and hip replacement, join my free weekly joint health newsletter. Comment NEWSLETTER and I’ll send you the link.

08/18/2026

After knee replacement, everyone says push harder, but that advice is setting you back.

And when you think about it, the advice makes NO SENSE. After any other operation you'd be told to rest and let your body recover. Nobody would tell you to push through the pain.

But with knee replacement we do the opposite…not because it works better, but because it's what everyone has always said.

But here's what ACTUALLY happens when you push too hard too soon. You FLOOD the knee with swelling and inflammation. That swelling drives MORE pain. The pain drives more STIFFNESS. And now you're FIGHTING your own recovery instead of working WITH it.

I learned this from a few surgeons who weren't afraid to buck the status quo. For the last year I've done the OPPOSITE with my patients. We LIMIT how much you walk early on, we stick to GENTLE range of motion at home, and we don't start real strengthening until around six weeks.

The results have been the best I've seen. Less pain, better motion, an EASIER recovery. Not because they pushed harder, but because they stopped fighting the swelling.

So if you're struggling early in your recovery and everyone keeps telling you no pain, no gain… maybe try the opposite.

Focus on getting the swelling down first. Ice and elevate more, limit your walking, and do gentle range of motion throughout the day. The strength comes later, and when you build it on a calm knee instead of an angry one, it becomes so much easier.

And if you want more cutting edge advice like this to help make your recovery after knee replacement easier, join my Joint Health Newsletter. Visit https://drkerbel.kit.com to join for free.

Dr. Yudi Kerbel, MD

08/27/2026

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