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Post-Op Complications of a Total Knee Replacement

Total knee replacements are a common operation done routinely around the world on patients with severe arthritis. The surgery has a high rate of success, and complications are rare. Most post-operative complications are anticipated and prophylactic medications or therapies are administered on a preventative basis. The patient's strict adherence to physician orders and commitment to post-operative physical therapy can prevent most complications from occurring.

  1. Deep Vein Thrombosis

    • Deep vein thrombosis is one of the most serious complications of total knee replacement surgery and can cause death of a blood clot, which loosens and travels through the bloodstream to the lungs. Early movement after surgery, therapeutic stockings, use of the foot pump, and anticoagulant medication help prevent clotting problems.

    Infection of the Wound Site

    • Infection is rare after total knee replacement surgery, occurring only in about 1 to 2.5 percent of cases. Antibiotics are given routinely for 24 hours after surgery to prevent infection, and additional courses of treatment may be given.

    Loss of Motion

    • Loss of range of motion can occur as a result of excess scar tissue forming at the site of the surgery. The rigorous physical therapy sessions following total knee replacement surgery help to break down this scar tissue, so encouraging the patient to attend therapy sessions and do follow-up exercises are critical to recovering complete range of motion. It may be necessary to manipulate the knee under an anesthetic to regain full range of motion.

    Nerve Injury

    • There are a number of conditions that are caused by nerve injury at the site of total knee replacement surgery. There may be numbness over the area or a sharp tingling when the scar area is touched. Most nerve problems dissipate in 6 to 12 months.

    Instability of the Knee Replacement

    • The stability of total knee replacement depends on the strength of the surrounding bone structures. This can cause problems in placing the prosthetic knee. Rarely, the knee itself may not be cemented properly, or there is dislocation of the kneecap post-operatively. These problems may require a second revision surgery.

    Fractures

    • Because of the fragility of their bones, older patients may suffer fractures of the bones either at the time of the operation or post-operatively. These injuries may significantly increase healing time and may lengthen the need for physical therapy.

    Arterial Injuries

    • Injuries to the arteries of the leg can occur because of their position directly behind the knee, but such injuries are extremely unlikely. However, such injuries are very serious and require a vascular surgeon to correct the problem.

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