Knee replacement - Risks 

Risks of surgery 

When to call the doctor

Call the doctor if:

  • you develop hot, reddened, hard or painful areas in your legs in the first few weeks after your operation – although this may just be bruising from the surgery, it could mean a blood clot has developed
  • you experience pains in your chest or breathlessness – although it is very rare, you could have a clot on your lung which needs urgent treatment

As with any operation, knee replacement surgery has risks as well as benefits. Most people who have a knee replacement do not experience serious complications.

Your anaesthetist and surgeon can answer questions you may have about your personal risks from anaesthetic or the surgery itself.

Complications occur in about one in 20 cases, but most are minor and can be successfully treated. Possible complications include:

  • Infection of the wound – this will usually be treated with antibiotics, but occasionally the wound can become deeply infected and require further surgery. In rare cases it may require replacement of the artificial knee joint  
  • Unexpected bleeding into the knee joint
  • Ligament, artery or nerve damage in the area around the knee joint
  • Blood clots or deep vein thrombosis (DVT) – clots may form in the leg veins as a result of reduced movement in the leg during the first few weeks after surgery. They can be prevented by using special support stockings, starting to walk or exercise soon after surgery, and by using anticoagulant medicines
  • Fracture in the bone around the artificial joint during or after surgery – treatment will depend on the location and extent of the fracture
  • Excess bone forming around the artificial knee joint and restricting movement of the knee – further surgery may be able to remove this and restore movement
  • Excess scar tissue forming and restricting movement of the knee – further surgery may be able to remove this and restore movement
  • The kneecap becoming dislocated – surgery can usually repair this
  • Numbness in the area around the wound scar
  • Allergic reaction – you may have an allergic reaction to the bone cement if this is used in your procedure

In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.

How long will a replacement knee last?

Wear and tear through everyday use means your replacement knee will not last forever. However, for most people it will last at least 15-20 years, especially if cared for properly and not put under too much strain.

Revision knee replacement surgery (replacing the replacement knee) is usually more complicated and a longer procedure than the original surgery. There is no set limit to the number of times you can have revision surgery, but it is widely accepted the artificial knee joint becomes less effective each time it is replaced.

Last reviewed: 23/04/2012

Next review due: 23/04/2014

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4 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

User760912 said on 01 April 2013

I had my first TKR in 2001 aged 45, and had no serious complications following surgery. I then had my other knee replaced in 2006. A different story this time. The pain though reduced is constantly there, the joint gets extremely cold,and lump has developed on the outer side of the knee. I have been told that this is caused by scar tissue from previous cartlidge operation,though I never had an issue prior to this.
On the upside I have very good flexion, am able to play some sports....but not my love of rugby though.
Walking is a great way to strengthen the leg, and reduces the need for pain management.

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David_E_B said on 08 June 2012

I had a TKR [left knee] in November 2008. I have good joint mobility but find the artificial joint uncomfortable and so have not had my right knee replaced. As I explained to the surgeon, I have exchanged one form of discomfort for another and in the main, my untreated knee is less bothersome than the one that was replaced.

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Margaret C said on 20 June 2011

I had a TKR on 26th April 2011 and was discharged from hospital 7 days later. 3 days after this I was readmitted with suspected wound infection and kept in for another 5 days. The clips were then removed and I was sent home, in more pain than on the first discharge. 10 days later and in excruciating pain I was readmitted for a third time for manipulation under anaesthetic. I was discharged 48 hours later with the pain level increasing by the day. Two weeks later I was readmitted again, for fluid to be drawn off for analysis. 24 hours after the initial operation I experienced a haematoma which I was told would delay my recovery. Last week I was told I had had another bleed. It is now 8 weeks since my operation, I am in considerable pain, and am still hobbling around with a stick. This is the very worst thing to happen to me and I wish I had never agreed to the operation - I am in far worse pain now than ever before. I am taking my full quota of paracetamol and codeine during the day, topped up with Amytriptiline and Tramadol at night. Despite this amount of medication I am still woken with pain throughout the night. How much longer will I have to suffer like this?

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chrisH1 said on 16 May 2011

I have had a total knee replacement but unfortunately it became infected and had to be revised, with implanted anti-biotics this unfortunately didn't work and had to be revised again same as before, finally the anti-biotics worked. The TKR lasted 12 months but the top implant became loose, so in he went again and replaced again. 12 months later I am in considerable pain the knee works ok with good movement in excess of 90 degrees, the quad muscles are strong, but I have lots of pain on the inside of the knee, not sure if this is scar tissue but if it is will it get better? can I do anything to improve it. If it's not what is it what can I do to get my life back? I am 57 years young

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Anaesthesia

Anaesthetics are extremely safe, but  carry a risk of minor side effects such as sickness and confusion (usually temporary). There is also a slight risk of serious complications.

The risk of death in a healthy person having routine surgery is very rare. Death occurs in around 1 in every 100,000 general anaesthetics given.

The risk is higher if you are older or have other health conditions, such as heart or lung disease.

Useful links

NHS Choices links

External links

Leaving hospital

Find out how you can be discharged from hospital and what arrangement you should make before returning home.

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