Knee replacement - Risks 

Risks of surgery 

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
  • if 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 have no problems at all. Complications occur in about 1 in 20 cases, but most of these are minor and can be successfully treated.

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

Risks include:

  • Infection of the wound. This will usually be treated with antibiotics, but occasionally the wound can become deeply infected and require further surgery. Very occasionally, it requires replacement of the artificial knee joint. 
  • 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.
  • 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.

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

  • show glossary terms
Antibiotics
Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. Examples of antibiotics include amoxicillin, streptomycin and erythromycin.
Artery
Arteries are blood vessels that carry blood from the heart to the rest of the body.
Blood vessel
Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.
Joint
Joints are the connection points between two bones that allow movement.
Lungs
Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.
Numbness
Numbness refers to a lack of sensation in a part of the body.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Tissue
Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.  
Veins
Veins are blood vessels that carry blood from the rest of the body back to the heart.

Last reviewed: 09/04/2010

Next review due: 09/04/2012

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2 Comments

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

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 they 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 who is having routine surgery is very rare. Death happens 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.

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