Complications of Knee Replacement Surgery

Complications of total knee replacement surgery are rare. They include general surgical complications, such as adverse reactions to anesthesia and infection, as well as complications specific to knee replacement surgery.

Possible complications from anesthesia include heart attack, stroke, pneumonia, and blood clots. It's important for the anesthesiologist to be aware of the patient’s medical history, especially past or current heart and/or lung issues, before surgery. After knee replacement surgery, anticoagulants may be used for a period of time to reduce the risk for blood clots.

In rare cases, infection can occur at the site of the incision or within the prosthesis. Risk for infection in the prosthetic joint persists for the rest of the patient's life. To reduce this risk, some patients who have undergone knee replacement surgery take preventive (prophylactic) antibiotics before future surgical or dental procedures. Other general risks of surgery include bleeding and scarring.

Complications specific to knee replacement surgery include:

  • injury to nerves or blood vessels in the leg
  • loosening or dislocation of the prosthesis
  • difference in leg length following the surgery
  • stiffness in the joint
  • pain that persists or worsens after surgery
  • allergic reaction to the cement used to affix the prosthesis

Complications can interfere with full recovery of the replaced joint.

In general, fewer than 2 percent of total knee replacement surgeries result in serious complications. Chronic health conditions (e.g., diabetes) can increase the risk for complications from knee replacement surgery. Patients should be sure to talk with their surgeon about these and other possible risks and about how they can be prevented or treated should they occur.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 11 Jan 2010

Last Modified: 28 Sep 2015