Knee replacement is one of the commonest surgical procedures performed in older adults, and its incidence is increasing rapidly.It is the only curative procedure for knee osteoarthritis, and it has excellent outcomes overall in terms of reoperation, functional outcomes and cost-effectiveness.However, a significant proportion of patients are dissatisfied after knee replacement surgery and there is a growing body of research into predictors of poor outcome and dissatisfaction.In this review, we delineate the place of knee replacement in the management of osteoarthritis, we discuss the alternatives, and discuss the predictors of success or failure after knee replacement surgery. 1