Whitney Frost, MD, an orthopedic surgeon with The Everett Clinic discusses total knee replacement. Typically there are three things that require a knee replacement, joint surfaces, malalignment, or ligaments that are unbalanced. All of which can be caused by one another. Surgery focuses on restoring the alignment, adjusting the ligaments and resurfacing the ends of the bones so that the patient can return to proper function. Advances in technology, including medications taken before surgery, state-of-the-art equipment and pain management resources help patients leave the hospital sooner and get moving quicker.