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.

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

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

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Medical complications

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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:

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• 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

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Surgical complications

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Infection

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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.

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Blood Clots (Deep Venous Thrombosis)

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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.

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Fractures or Breaks in the Bone

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

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Retained or loose cement

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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.

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Stiffness in the Knee

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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.

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Implant wear or subsidence

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The implant is a man-made device that will wear out over time. This usually occurs 10-15 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 total knee replacement is required if pain accompanies implant wear or subsidence.

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Wound Irritation or Breakdown

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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.

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

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Cosmetic Appearance

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

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Leg length Inequality

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

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Patella Problems

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The Patella (knee cap) can track poorly, impinge on the implant, and in rare cases, dislocate.

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Ligament Injuries

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There are a number of ligaments surrounding the knee. These ligaments can be torn during surgery or break or stretch out any time afterwards. Surgery may be required to correct this problem.

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Damage to Nerves and Blood Vessels

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Rarely these can be damaged at the time of surgery. If recognized they are repaired but a second operation may be required. Nerve damage can cause a loss of feeling or movement below the knee and can be permanent.

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Conversion to Total Knee Replacement

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A partial knee replacement typically lasts 10 years or more, but can fail earlier. Typical causes of failure include implant wear, subsidence (sinking of the implant into the bone), progression of arthritis in other parts of the knee, and, rarely, infection. In most cases, the failed implant makes the knee feel like it did before the partial knee replacement. In cases of failure, the partial knee replacement can be converted to a total knee replacement.

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Summary

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Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it could mean the difference between leading a normal life or putting up with a debilitating condition. Surgery can be regarded as part of your treatment plan-it may help to restore function to your damaged joints as well as relieve pain.

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Partial knee replacement is one of the most successful operations available today. It is an excellent procedure to improve the quality of life, take away pain and improve function. In general 90% of partial knee replacements survive 10 years, depending on age and activity level.

Surgery is only offered once non-operative treatment has failed. It is an important decision to make and ultimately it is an informed decision between you, your surgeon, family and medical practitioner.

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Although most people are extremely happy with their new knee, complications can occur and you must be aware of these prior to making a decision. If you are undecided, it is best to wait until you are sure this is the procedure for you.

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