Risks of having any Total Knee Replacement
Infection
Infection is uncommon occurring in less than 2% of cases.
It is usual for each patient to be is given intravenous antibiotics at the time of their joint surgery and after wards.
Infection in the post-operative period in most patients is treatable. Patients may be treated with antibiotics for a longer period than normal and wash out of the joint will be required.
In some cases, the implant will be removed to treat the infection before reimplanting a new joint ether as stage 1 (new implants put in the 1st time with antibiotics in the joint) or 2 stage procedure where patients may have a cement spacer for a short period (6-12 weeks) before the definitive procedure.
Infection is uncommon and we take detailed precautions to avoid this problem.
Blood Clots (deep vein thrombosis, pulmonary embolism)
Another risk is blood clots after a joint replacement.
Since our patients are mobilized very soon after surgery, this risk is small.
Calf compressors during and after surgery also help.
After surgery “TED stockings” and low doses of aspirin or other anticoagulation (blood thinner) medications are prescribed depending on the patient’s medical history.
In patients without any history of thromboembolic (blood clot) problems, we advise taking aspirin, 300 mg per day, for a period of six weeks. This is normal aspirin, and if you take low dose aspirin, such as Cartia, which is 100 mg per tablet, three of these need to be taken per day.
These measures are in place to reduce the risk of forming a clot.
In the event the patient is diagnosed with a blood clot, intravenous or subcutaneous anticoagulation therapy may be required.
There is no perfect treatment, and while trying to decrease the significant risk of deep vein thrombosis and the possibility of more serious complications, such as pulmonary embolism (blood clots breaking off and traveling to the lungs), other potential side effects (such as bleeding) can occur with the drugs used to decrease this complication. These medications require extreme care in their use.
Prosthetic Loosening
Loosening or excessive wear of the components (plastic, metal and cement fatigue) is another complication of joint surgery. Loosening can occur in one or all component.
Running and jumping should be avoided and care taken to avoid weight gain. The potential risk is approximately 1% per year. This means, it is a gradual process, characterised by increasing discomfort. In most cases if the components become loose, it can be corrected by another surgical procedure, replacing the worn or loose component.
Stiffness in the Knee
A decrease in motion of a joint is also a potential risk. The joint condition prior to surgery will have some bearing on the movement post surgery. Physiotherapy and exercise are encouraged prior to surgery. Post surgery, if the joint remains stiff, physiotherapy or manipulation can improve the range of motion in the joint.
Dislocation
Dislocation of components is a possible risk of knee joint replacements. It is very rare, approximately less than 1% of components dislocate in the immediate post-operative period.
In the vast majority of these cases treatment of this problem requires manipulation of the joint. If unsuccessful in relocating the prosthesis, a second open surgical procedure may be necessary to fix the problem.
Nerve Damage
Nerves (usually under the skin) can be traumatised at the time of the operation through stretching and occasionally due to swelling after surgery. We take every precautions to protect the nerves during surgery. If nerve damage occurs – rest and further examination of the nerve will be required, and possible further surgery.
Other Complications
Other complications that can occur include, instrument failure, muscle wasting, artery or vein trauma, drug reactions, instrument or implant breakage and loss of income. These complications are rare. It is important to be aware of complications when considering joint surgery.