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Risks And Complications Of Total Knee Replacement Surgery
Knee replacement surgery is now a standard procedure. Though severe complications are rare, it's a good idea to be aware of the risks before entering the operating room.
Over 790,000 people undergo knee replacement surgery every year in the United States. It's a common procedure, but complications can develop during and after the procedure.
That said, research also suggests that complications occur in just 7.1% of cases of people under the age of 80. They are more prevalent in older adults over the age of 80 (34.3%).
Read on to learn more about the possible complications during and after knee replacement surgery.
A surgeon may use general or local anesthesia during surgery. It is usually safe, but it can have side effects such as vomiting, dizziness, sore throat, or shivering.
Other possible effects include:
To reduce the chance of problems, be sure to tell your doctor in advance if you take or use any of the following:
These can interact with medications and may interfere with anesthesia.
There is a risk of developing a blood clot after surgery, such as deep vein thrombosis (DVT).
If a clot travels through the bloodstream and causes a blockage in the lungs, a pulmonary embolism (PE) may result. This can be life threatening.
Blood clots can occur during or after surgery, but they are more common after orthopedic surgeries like knee replacements.
That said, DVT and PE are still relatively rare complications, developing in 0.6-3.0% of knee replacement cases. To reduce the chance of a blood clot after your procedure, your doctor will prescribe a blood thinner following the surgery.
Learn more: Tips to prevent blood clots after surgery.
Infection can occur if bacteria enter the knee joint during or after surgery.
Healthcare providers reduce this risk by:
That said, infection can still happen, and this can become a severe and life threatening complication, potentially leading to sepsis without immediate treatment.
Some people are more prone to infections as their immune system is compromised by a medical condition or the use of certain medications. Doctors usually give antibiotics during the surgery to lower the chance of infection.
Learn more: How to tell if you have an infection following surgery and what to know about Infections after a knee replacement
The surgeon will use sutures or staples to close the wound. They typically remove these after about 2 weeks.
Complications that can arise include:
One 2021 study identified a 7% rate of wound complications after total knee replacement, and research suggests they may be more common and more serious after a repeat procedure.
To reduce the risk of problems, monitor the wound and inform your doctor if it is not healing or if it continues to bleed.
This includes people with diabetes and HIV, those who use immunosuppressant medications, and those who take medication following a transplant.
Eating a balanced diet before the procedure that includes a lot of protein, fruit, and vegetables, especially those containing vitamin C, can help your wound heal better afterward.
Learn more about surgical wounds and their complications.
It is normal to have some pain after surgery, but this should improve in time.
Most people recover well from knee replacement surgery and experience an improvement in pain afterward.
The most common complication is that people don't like the way their new knee works, and in rare cases, pain may persist.
In a 2022 study of 605 people who underwent a total knee replacement procedure, 12% still experienced pain at rest and 38% experienced pain during movement two years after surgery.
Speak with your doctor if you have ongoing or worsening pain.
Learn more: How to manage pain, swelling, and bruising after a total knee replacement.
In rare cases, a person may need a blood transfusion after a knee replacement procedure. Multiple studies suggest the rate of transfusion after knee replacement is often lower at 1-5.1%.
Blood banks in the United States screen all blood for possible infections. There should not be any risk of complications due to a transfusion.
Some people may experience an allergic reaction to the metal used in the artificial knee joint. This is called metal hypersensitivity. Doctors don't fully understand why it develops, and there isn't a lot of research to support it as a clear diagnosis yet.
That said, according to a 2019 study, the prevalence of such a reaction among 233 people who underwent a total knee replacement was found to be just over 15%. The most common metal people reacted to was chromium at nearly 12%, followed by nickel at almost 9% and cobalt at about 6%. Implants may contain titanium or a cobalt-chromium-based alloy.
While this isn't so common, if you already know you have a sensitivity to metal from other exposures, be sure to tell your surgeon. Also, tell them of other allergies you may have before surgery.
According to a 2020 study of 47,585 knee replacement procedures, 0.4% of people experienced nerve palsy, which can mean the loss of sensation in the leg or the inability to hold the leg up (foot drop).
Other types of nerve damage include numbness, weakness, tingling, or a burning or prickling sensation
If you notice these symptoms, contact your doctor. Treatment will depend on the extent of the damage.
Scar tissue or other complications can sometimes affect motion in the knee. In a 2021 study, of 1350 total knee replacement procedures, 33 people, or 2.44%, experienced stiffness after surgery.
Special exercises or physical therapy can help resolve this. If there is severe stiffness, the person may need a follow-up procedure to break up the scar tissue or adjust the prosthesis inside the knee.
If there is no additional problem, ways of preventing stiffness include getting regular exercise and telling your doctor if stiffness does not reduce in time.
Sometimes, there may be a problem with the implant. For example:
Generally, this isn't so common. More than 82% of replacement knee joints are still working 25 years later, according to figures published in 2018.
That saud, if these problems occur, the person may need a follow-up procedure, or revision, to fix the problem.
Learn more: Clinical outcomes and statistics of knee replacement.
What is the most common complication of total knee replacement?It's difficult to define the absolute most common complication of total knee replacement because this can vary by hospital and geographic area and can also be influenced by various social and economic factors.
That said, a 2017 study examining a Medicare beneficiary population found that the overall complication rate for knee replacement was 2.09%. In this study, the most common complication type for knee replacements during the procedure was pneumonia at 0.50%, whereas the most common complication after discharge was infection at 0.46%.
Another 2022 study separated complication rates by in-patient vs outpatient procedures. In-patient means the person was hospitalized for the procedure, whereas out-patient means that person could go home that day. Overall, in-patient procedures had more complications than out-patient procedures. In this study, a superficial surgical site infection and urinary tract infection (UTI) were most common for both types of procedures.
Can too much walking damage a knee replacement?Walking doesn't necessarily have to damage a knee replacement if you allow your knee to heal and add it to your movement routine gradually in consultation with your doctor.
In general, research suggests you have a lower risk of falling after a joint replacement. That said, older adults have a slightly higher risk. According to a 2018 study, 17.2% of 134 people who had the procedure fell at least once 6 months after surgery. In two-thirds of those cases, the fall occurred while walking.
When you're ready to walk, begin by using a handrail on stairs, and keep away from messy floors or slippery terrain that may cause you to trip.
Learn more: What exercises (or movements) to avoid after a knee replacement
How do you know if your knee replacement is failing?Signs of a failing knee replacement can include increased instability or pain, infection, or bone fracture. Sometimes, small pieces of the implant can break off and cause joint inflammation.
Learn more: What is knee replacement revision surgery, and when do you need it?
Total knee replacement is a standard procedure that thousands of people undergo every year. Many of them have no complications.
It is essential to know what the risks are and how to spot the signs of a complication.
This will help you make an informed decision about whether to go ahead. It will also equip you to take action if a problem does arise.
Lauren Boebert Undergoes Surgery For Blood Clot In Her Leg: 'Looking Forward To Making A Full Recovery'
Lauren Boebert is recovering after undergoing a "successful" surgery Tuesday morning for a blood clot in her leg.
The Republican congresswoman, 37, was admitted to UCHealth Medical Center of the Rockies in Loveland on Monday, according to a statement from her campaign, after experienced "severe swelling in her upper left leg."
Doctors then discovered a blood clot in a CT scan, leading them to diagnose the Representative from Colorado with May-Thurner Syndrome, a life-threatening condition that can lead to a pulmonary embolism if untreated.
May-Thurner Syndrome, per the Cleveland Clinic, occurs when "the right iliac artery — which sends blood to your right leg — presses on the left iliac vein, which carries blood from your left leg to your heart," Also known as Cockett syndrome or Iliac vein compression syndrome, symptoms can range from swelling, skin discoloration and feelings of heaviness to open sores (ulcers) and throbbing pain.
It's more common with in women, and in adults ages 20 to 50.
Lauren Boebert on Jan. 10, 2023.Jabin Botsford/The Washington Post via Getty
Boebert — who shares four teenage sons with ex-husband Jayson Boebert — is expected to make a "full recovery" with "no significant concerns for her long-term health," Boebert's campaign said, noting that doctors removed the clot and inserted a stent into her leg, Her ability to perform her Congresswoman duties won't be affected, they added.
In the release, Boebert expressed her gratitude to the medical staff at the center.
"I want to thank Dr. Rebecca Bade and the entire team at UCHealth Medical Center of the Rockies for their great care and providing helpful insight on my recent diagnosis," Boebert said. "I'm looking forward to making a full recovery and getting back to Congress to continue fighting for Colorado."
Lauren Boebert in September 2023.Anna Moneymaker/Getty
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Physician Dr. Bade also added, "We successfully performed surgery on the Congresswoman this morning and expect her to make a full recovery."
"Patients with May-Thurner Syndrome who undergo the procedure to restore blood flow are able to live and work just as they have in the past after a brief recovery," Dr. Bade said.
Boebert, who has served as the U.S. Representative for Colorado's 3rd congressional district since 2021, is currently seeking a third term.
Paulina Porizkova, 59, Is 'shocked By The Absence Of Pain' 3 Months After Double Hip Replacement — Here's What To Know About The Surgery
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.
Paulina Porizkova is sharing an update after her double hip replacement surgery, which she says she doesn't regret. (Photo by: Nathan Congleton/NBC via Getty Images)
Hip replacements can be a life-changing procedure, as Paulina Porizkova, 59, shared with her followers. The model says she's shocked at the "absence of pain" she now feels.
"I'm now at three months post-op," she wrote on Instagram, in an update on her recovery after undergoing a double hip replacement. Initially, her rehabilitation involved walking for two weeks post-surgery before moving to physical therapy twice a week for the next four weeks, while doing daily exercises in between. For the next six weeks, she had physical therapy twice a week at home and exercised regularly.
Porizkova also incorporated daily hikes and massages into her routine. Despite her healthy diet of vegan smoothies and home-cooked dinners, she noticed a ten-pound weight gain. However, the results have been worth it: "I am way more flexible than in the last two years. I have no pain when I walk," she wrote.
I had to be in so much pain that sawing off my hip bones sounded like a great idea.Paulina Porizkova, via Instagram
Although she still experiences occasional pulling sensations, she's thrilled with her new mobility. "Every morning when I jump out of bed, I'm shocked by the absence of pain," she explained. "Likewise, everytime I bend over to scoop dog poo. Or cross my legs. Or stand for a while. Or walk more than a block. Or drive my Vespa."
Porizkova even joked about the unexpected benefits: "It has been an unexpected bonus to my sex life," she wrote alongside a winky-face emoji.
For those considering hip replacements, she offered encouragement: "You will not regret it."
Earlier this year, Porizkova made headlines for documenting her surgery journey. The model shared the news with followers on Instagram writing, "It turns out I was born with congenital hip dysplasia — and because of that, the cartilage in my hips is worn out."
More than 117,000 hip and knee replacement surgeries were performed from 2021 to 2022, a 5.9 per cent increase compared to the previous year, the Canadian Institute for Health Information reports.
With the procedure on the rise thanks to longer life expectancies, increased risk factors, and a growing baby boomer population, here's what you need to know about the surgery, risks, recovery time and more.
What is hip replacement surgery?Hip replacement surgery, medically known as arthroplasty, is the second most common inpatient surgery in Canada. The procedure is designed to alleviate pain and improve functionality in individuals with severe hip joint damage. The surgery involves removing the damaged joint and replacing it with an artificial implant. The artificial joint mimics the natural hip joint's movement, allowing for smoother mobility and improved quality of life and are typically made of metal, polyethylene (plastic), or ceramic.
There are typically three different approaches to performing hip replacement surgery, including traditional or posterior approach, anterior approach and lateral approach. The choice of approach depends on a variety of factors, including the surgeon's preference, patient anatomy, and the specific condition being treated.
Hip replacements are very common surgeries in patients over the age of 60, Dr. Jason Werle, senior medical director at Alberta Health Services tells Yahoo Canada. Celebrities like Jane Fonda, Steve Carell, Lionel Richie and Madonna have all had the procedure done.
"[But] younger patients in their 30s to 50s can have other conditions that may require a hip replacement at a young age," he explains. "The end result is a painful hip with a restricted range of motion that may require surgery."
Are there risks to having hip replacement surgery?Although uncommon, some potential hip replacement complications include:
Double hip replacements come with a slightly increased risk of infection, blood clots, and blood transfusion, "but the risks and benefits have to be weighed when deciding whether to proceed [with surgery]," Werle says.
People who menstruate or who have anemia may be at a higher risk of blood transfusion because of blood loss. It's also possible for patients to require more than one surgery, however only seven per cent of surgeries from 2021 to 2022 required a revision.
What is recovery like for a hip replacement surgery?While Porizkova was up and walking on her own within 18 hours of her surgery, the same can't be said for everyone.
Recovery from hip replacement surgery is a structured process that involves multiple phases. Initial hospitalization lasts one to three days, during which patients receive post-operative care. Rehabilitation and physiotherapy follow, focusing on restoring joint function and building strength gradually.
"Generally, patients stay [until] they can weight bear on the operative leg, and manage their pain and exercises independently at home," Werle says. "Some patients who are motivated and have support at home can be discharged the same day as their procedure, [which] is increasing across the country partly due to changes in care during the pandemic."
Hip replacements have a shorter recovery time than knee replacements. (Image via Getty Images)
A double procedure is actually the same recovery length as a single procedure. "That's one of the advantages to [double] procedures that has to be balanced with the slightly increased risks," Werle explains. Interestingly, hip replacement patients tend to recover quicker than knee replacement patients.
"A knee that doesn't bend causes all kinds of daily living challenges," he adds. "For hip replacements, generally patients just walk as part of their recovery as range of motion is not a heavy focus post-op."
From hip surgery to getting back to full mobility, the recovery period can take up to two months, but it depends on other factors like age, lifestyle, pre-existing conditions, and how active you were before surgery.
Teresa Stebe, 88, found out she needed a hip replacement two years ago after having trouble moving her legs, getting up, and bending over to tend to her garden at her Montreal home. It took her a while to recover from the procedure, she says — one to two weeks of physiotherapy followed by two to three months of slow recovery, which her doctors said went well.
Now I can go back to doing the things I love.Teresa Stebe
"At first I was limited because I live in a house with my husband and using stairs, which is part of my daily life, wasn't an option," Stebe tells Yahoo Canada. "I had a cane to help with distance and going around, but other than that I didn't feel too limited."
"I'm really happy I did it," she says. "Now I can go back to doing the things I love."
How do you know if you need a hip replacement?Jan Fong-Lee, 56, had her first hip replacement at the age of 54 — and her second eight months later. Before her surgery, Fong-Lee tells Yahoo Canada she experienced decreased mobility and pain, and difficult performing normal daily activities for approximately 10 years.
Other warning signs that something may be wrong with your hips include stiffness, damaged hip joints, and inflammation or swelling.
"I wouldn't be able to walk too far or do stairs," Fong-Lee says. "I would get flare ups with pain thinking I injured it working out."
I wish I had done it earlierJan Fong-Lee
Fong-Lee says she has a high pain threshold and waited for it to get really bad before going to the doctor and discovering she had osteoarthritis. She also learned she had developed necrosis (a breakdown of tissue) and a fracture on her left hip.
While her right hip wasn't bad at the time, it quickly progressed to be bone-on-bone about two months after her first surgery. "My doctor said I could explore getting an injection for the pain that could buy me a year if it worked," she says, "but I didn't want to put it off."
An avid runner with an active lifestyle, Fong-Lee was relieved to have an answer to her pain. "I felt I was young to be having it, but also ready as I needed to get active again," she says. "The pain made me depressed; I couldn't do the things I loved.
"I wish I had done it earlier."
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