Knee replacements have been highly successful for more than 30 years. According to the US National Institutes of Health, 9 out of 10 patients who undergo the procedure report improved pain relief, knee function, and overall health-related quality of life.1 And because medicine is always developing new materials and procedures, the results continue to get better. The complication rate following total knee replacement is low. Serious complications, such as knee-joint infection, occur in approximately 2.0% of patients.2 Major medical complications, such as heart attack or stroke, occur even less frequently. (Of course, chronic illnesses may increase the potential for complications.)
Every surgical procedure has some risks and benefits. Your individual results will depend on your personal circumstances, and recovery takes time. While there can be no guarantee of success, benefits can include pain relief and return of normal use of the knee.
Each of the following reactions or complications can occur during and after surgery and may require medical attention (such as further surgery) and implant removal:
Blood clots in the leg veins are the most common complication of knee replacement surgery. Your surgeon will outline a prevention program. This may include periodic elevation of your legs, lower-leg exercises to increase circulation, support stockings, and medication to thin your blood.
Infection is a risk with any surgical procedure. According to the American Academy of Orthopedic Surgeons, approximately 2.0% of patients get an infection in the first two years.2 When infection occurs after total knee replacement, it is most commonly caused by bacteria that enter the bloodstream during dental procedures or from urinary tract, skin, or fingernail infections. Although uncommon, when these complications occur, they can delay full recovery.
For the first two years after your knee replacement, you must take preventive antibiotics before dental or surgical procedures that could allow bacteria to enter your bloodstream. After two years, talk to your orthopedist and your dentist to see if you still need preventive antibiotics before other procedures.
The bone next to the knee implant may break down (called osteolysis) because of your body's reaction to particles that may be caused by:
Implant fracture has been reported following total knee replacement. This is typically caused by:
To minimize the possibility for implant fracture, it is important to follow medical instructions and to avoid excessive or inappropriate activity.
Given the risks, your doctor may decide that knee replacement surgery is not appropriate if: