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Total Knee Replacement

As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.

It is important that you are informed of these risks before the surgery takes place.

Complications can be medical (general) or surgical complications specific to the knee.

Medical complications

Medical complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include:

  • Allergic reactions to medications

  • Blood loss requiring transfusion with its low risk of disease transmission

  • Heart attacks, strokes, kidney failure, pneumonia, bladder infections

  • Complications from nerve blocks such as infection or nerve damage

  • Serious medical problems can lead to ongoing health concerns, prolonged hospitalization or rarely death

Surgical complications


Infection can occur with any operation. In the knee, this can be superficial or deep. Infection rates are approximately 1%. If it occurs, it can be treated with antibiotics but may require further surgery. Very rarely your knee may need to be removed to eradicate infection. The Hospital for Special Surgery has the lowest infection rate in the region.

Blood Clots (Deep Venous Thrombosis)

These can form in the calf muscles and can travel to the lung (Pulmonary embolism). These can occasionally be serious and even life threatening. If you get calf pain or shortness of breath at any stage, you should notify Dr. Pearle, your medical doctor, or go directly to the Emergency Room.

Fractures or Breaks in the Bone

Fractures or breaks can occur during surgery or afterwards if you fall. To repair these, you may require surgery.

Retained or loose cement

The prosthesis is cemented into place in the knee. Pieces of cement can break off at any time after the surgery. These fragments may cause pain or damage to the knee and in some cases, may need to be removed with an additional surgical procedure.

Stiffness in the Knee

Ideally, your knee should bend beyond 130 degrees but on occasion, may not bend as well as expected. Sometimes manipulations are required. This means going to the operating room where the knee is bent for you while under anesthetic.

Implant wear or subsidence

The implant is a man-made device that will wear out over time. This usually occurs 20-25 years after implantation. Occasionally, the implant wears out rapidly or subsides (sinks) into the underlying bone within the first couple years after implantation. A conversion to a second total knee replacement is required if pain accompanies implant wear or subsidence.

Wound Irritation or Breakdown

The operation will always cut some skin nerves, so you will inevitably have some numbness around the wound. This does not affect the function of your joint. You can also get some aching around the scar. Vitamin E cream and massaging can help reduce this.

Occasionally, you can get reactions to the sutures or a wound breakdown that may require antibiotics or rarely, further surgery.

Cosmetic Appearance

The knee may look different than it was because it is put into a more normal alignment to allow proper function.

Leg length Inequality

This is also due to the fact that a corrected knee is more straight and is unavoidable.

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