For the first time in Sanad Hospital, the orthopedic surgery department has succeeded in performing total knee replacement for a Thai lady with severe osteoarthritis. The lady is 50 years old, had severe pain, swelling and knee deformities that caused difficulty in walking. Symptoms increased in the last 2 years. She tried medical, diet and physiotherapy but fails to manage her symptoms. Thus, she was advised by her orthopedic surgeon to undergo “knee replacement surgery”. Patient had lot of concerns at the beginning but finally, she decided to do the surgery. Under general anesthesia, surgery was successfully performed on Sunday dec 14, 2014. Patient was able to move her joint the day after surgery and have dramatic improvement in her condition. She is expected to move comfortably and enjoy most activities within few weeks. Knee replacement surgery is performed to treat advanced or end-stage arthritis. When arthritis in the knee joint or joints had progressed to the point where medical management is not effective, or deformity has become severe and debilitating, knee replacement surgery is indicated.