Total knee surgery is safe and effective. The vast majority of patients who undergo total knee replacement surgery do not experience complications. Your orthopaedic surgeon and the hospital staff will do their best to minimize the risk of these complications from occurring. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can or limit your full recovery.
The following write-up describes some of the complications associated with total knee replacement surgery. This list is not exhaustive and your surgeon and his clinical assistants would discuss with you other possible complications. Please ask your surgeon if you have any questions about this or other aspects of the surgery.
Replacement surgery in India your anesthetist is the best person to discuss this with you prior to your surgery. If you have any questions regarding the type of anesthesia you are going to receive, or if you have had previous problems with anesthesia, please do not forget to let your anesthetist know. Some medications interact with anesthetic agents, so it is necessary to inform your anesthetist of any medication you are taking.
The risk of infection after total knee replacement is between 1-2%. Infection is more common amongst patients who have a condition affecting their immune system. Infections may be superficial or deep. Deep infections are more serious and further surgical treatment and prolonged hospitalization may be required for uncontrolled infections. This is fortunately very rare. Treatment of infection might mean multiple trips to operating theater for drainage and cleaning of wound. If the infection is deep, your surgeon might elect to remove all the metal and plastic parts, together with all non-visible tissues. Depending on the type and severity of infection, antibiotics may be administered through the veins for a period of two to six weeks. When the infection is controlled, a new prosthesis can then be implanted.
Deep venous thrombosis and pulmonary embolism
replacement surgery in kolkataKnee replacement in India, clotting of the blood in the veins of the legs is a recognized complication and perhaps the most common complication of total knee replacement surgery. These clots, unfortunately, sometimes get detached and travel in the blood stream to reach the lungs. This is known as a pulmonary embolism. This is a serious condition and life is sometimes at risk. Every effort is made to try to minimize the occurrence of these complications. These measures include daily or twice daily injections of a substance into the abdominal wall that thins the blood and reduces the risk of clotting. Your medical condition and other considerations will influence the use and dosage of this substance (prophylactic anti - coagulants). You will be provided with white compressive leg stockings to wear. Usually these stockings are worn for a total period of six weeks.
Clots in the lungs cause shortness of breath and chest pain. Inform the nursing staff, if you experience such symptoms. Treatment is by oxygenation and administration of blood thinners (e.g. heparin)
Instability/ Dislocation of the kneecap
Hip replacement surgery in India, dislocation of the kneecap, or more rarely dislocation of the plastic cushion (in a mobile bearing knee replacement), can happen after total knee replacement. In case the kneecap does shift to the outer portion of the knee, severe pains might ensue. Realignment of the kneecap generally requires a further surgical procedure. At times dislocation results from erroneous positioning of the components and a revision operation may be necessary. However, with rapid advancements in the techniques for knee replacements, such dislocation risks have reduced considerably.
Fat from the bone marrow can reach circulation and could travel to the lungs. This condition is quite similar to the previous complication of pulmonary embolism. That is why it is called a fat embolism. The symptoms are quite similar to those of pulmonary embolism.
knee replacement in kolkataPost-operative stiffness can lead to a certain degree of mobility loss for the patients. Instead of the general knee joint mobility of 0-135 degrees, a person who has undergone surgery can achieve mobility only up to 110 degrees. However, with the increasing popularity of medically approved ‘high-flex' knees and the implants they contain, such mobility losses can be reduced to a minimum. The amount of mobility loss also depends on how flexible the knee joint of a patient was, before the operation.
Wound necrosis (which means that the wound edges turn black) and wound breakdown (which means that the surgical wound opens up) are two complications that sometimes occur. When these complications occur, a further operation to repair the wound may be necessary.
General medical problems
General medical complications can sometimes occur after any major surgery. These complications includes heart attack, strokes, lung collapse, pneumonia, various heart problems, kidney dysfunction and bed sores.
Pressure sores, especially of the heel area, can develop within 24 hours of lying in the bed. They can be prevented by avoiding inactivity in bed. It is necessary that you relieve pressure from the heel and buttocks (sacral area) regularly. If you notice sensations of burning or pain in pressure areas, you should inform your doctor or the nursing staff.
Vessel and nerve injury
A number of large blood vessels and the main nerves that supply the lower limb surround the knee. These structures are always at risk from stretching or direct injury. Every precaution is taken to minimize the risk of these structures. The lateral popliteal nerve is at particular risk of injury in total knee replacement surgery. Other nerves and vessels can be compromised during surgery. Nerve and vessel injuries can result in long-term disability.
It is very common for some superficial sensory nerves to be divided during surgical exposure of the knee. This can result in altered or reduced sensation over the front of the knee. Occasionally a swelling of the nerves develops. This uncommon complication may cause hypersensitivity of the skin or wound.
Fractures of the shaft of the femur and the tibial bone occur sometimes, especially when the bones are soft and weak. The complication is more common during revision knee surgery. Fractures also occur if you sustain a heavy fall following surgery.
Loosening and wear
hip replacement surgery in kolkataYour new knee replacement is not expected to last forever. More than 95% of knee replacements are expected to be functioning well after fifteen years from implantation. You can help to prolong the life expectancy of your knee by looking after it. This means that you should remain active but not over active. Squatting, heavy impact sports and activities, and running should be avoided. Should the prosthesis loosen or wear excessively, a revision operation may be needed to treat the problem.
In performing a total knee replacement, your surgeon aims to align the knee to take into account the weight - bearing axis of the leg. A difference in alignment of the knees is common after surgery particularly if only one knee is replaced.
Most patients have a mild (imp after surgery and for about six months. The limp usually disappears or at least subsides significantly after six months.
Your knee is expected to move from being fully straight to at least ninety degrees of bending. There is an element of unpredictability about the range of motion after total knee replacement surgery. Some knees are stiffer than others are. If your surgeon is not happy with the amount of bending you are getting, he may decide to perform a manipulation of the knee under anesthetic and try to improve the range of motion in your knee. This is usually done between four and eight weeks after the operation.