Knee Replacement Risks and Complications

Table of ContentsView AllTable of ContentsKnee StiffnessClicking or PoppingDurabilityInfectionBlood ClotsNerve InjuryReduced Range of MotionReduce RiskWhen to Seek Medical Care

Table of ContentsView All

View All

Table of Contents

Knee Stiffness

Clicking or Popping

Durability

Infection

Blood Clots

Nerve Injury

Reduced Range of Motion

Reduce Risk

When to Seek Medical Care

Although knee replacement risks are uncommon and surgery can help improve mobility and pain issues, you may also experience problems. Possible complications include stiffness, clicking, wearing out of the implant, possible infection, blood clots, nerve injury, and reduced range of motion.

While problems can occur, knee replacement, also called knee arthroplasty, typically has high success rates. Serious problems occur in less than 2% of individuals.

One of the most common problems people experience after knee replacement is astiff knee joint.This can cause difficulty with activities that require a lot of bending, including going down stairs, sitting in a chair, or getting out of a car.

Management of a stiff knee joint after replacement may include appropriatephysical therapyand pain management, as well as minor surgical interventions, and, more rarely, revision surgery, or a second knee replacement.

Risk factors for having a stiff knee joint after knee replacement include:

Because artificial joints are made of metal and plastic, it is not uncommon to hearclicking, clunking, or poppingwhen the knee bends back and forth. In general, noise without pain is not usually a problem.

Some potential causes of clicking, clunking, or popping include:

Wearing Out of Implants

Over 90% of knee replacements last longer than 15 years. However, in some cases, they can wear out and a revision knee replacement may be necessary.

Knee replacements are more likely to wear out if:

Infectionsare a serious complication of knee replacement. However, they only occur in less than 2% of individuals who have had this procedure.

Knee replacement infections are generally separated into early and late infections:

Preventative steps, such as taking your prescribed antibiotics before and after surgery, can help reduce the risk of infection.

Blood clotscommonly occur in the large veins of the leg after knee replacement and can cause pain and swelling. In some circumstances, the blood clot can make its way to the lungs. This condition, known as apulmonary embolism, can lead to serious and potentially life-threatening problems.

To decrease the risk of a blood clot, individuals may be:

Although uncommon, nerve injury following knee replacement can cause a debilitating loss of mobility andneuropathic pain. Further, aggressivetreatment with pain medicationscan lead to a variety of undesirable side effects ranging from GI issues to addiction.

A 2019 study found that females and people with spinal diseases or those who had undergone spinal surgery were at higher risk for post-operative nerve injury following knee replacement.

Other potential risk factors for nerve injury include:

Various risk factors forrange of motionissues after knee replacement have been identified, including:

Other associated causes, such as infection, the build-up of too muchscar tissuepost-surgery,complex regional pain syndrome(a neurological condition that causes continuous pain and other symptoms), andheterotopic ossification(bone growing in tissues where it should not be) have also been identified.

Managing reduced range of motion typically involves assessment and treatment in stages, starting withphysical therapy. Manipulation under anesthesia may be tried if range of motion does not improve in the short term.

Beyond this point, surgical intervention is considered. If stiffness is due to a surgical error, revision arthroplasty is indicated.

How to Reduce Your Risk

Knee replacement is not a high-risk surgery. Most people have no complications. Further, the risk of death is 0.6%, or about one in 200 surgeries.

How to Reduce Your RiskYou can improve the chances of a speedy, problem-free recovery through pre-surgical strategies like:Practicing deep breathing to improve lung healthEating healthfullyQuitting smokingLosing weight, if needed

You can improve the chances of a speedy, problem-free recovery through pre-surgical strategies like:Practicing deep breathing to improve lung healthEating healthfullyQuitting smokingLosing weight, if needed

You can improve the chances of a speedy, problem-free recovery through pre-surgical strategies like:

When to Call Your Healthcare Provider

Contact your healthcare provider if you experience:

Seek immediate medical attention if you experience:

Summary

Knee replacement risks are uncommon but include stiffness, clicking, wearing out of the implant, possible infection, blood clots, nerve injury, and reduced range of motion.

Knee replacement typically has a high success rate, with serious problems occurring in less than 2% of individuals. Treatment depends on the nature of the complication but most involve pain management, physical therapy, or (occasionally) surgical revision.

10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.OrthoInfo.Total knee replacement.Rodríguez-Merchán EC.The stiff total knee arthroplasty: causes, treatment modalities and results.EFORT Open Rev. 2019;4(10):602-610. doi:10.1302/2058-5241.4.180105Nam D, Barrack T, Nunley RM, Barrack RL.What is the frequency of noise generation in modern knee arthroplasty and is it associated with residual symptoms?Clinical Orthopaedics & Related Research. 2017;475(1):83-90. doi:10.1007/s11999-016-4701-yAmerican Academy of Orthopaedic Surgeons.Revision total knee replacement.American Academy of Orthopaedic Surgeons.Joint replacement infection.Shetty T, Nguyen JT, Sasaki M, et al.Risk factors for acute nerve injury after total knee arthroplasty.Muscle Nerve. 2018;57(6):946-950. doi:10.1002/mus.26045Manrique J, Gomez MM, Parvizi J.Stiffness after total knee arthroplasty.J Knee Surg. 2015;28(2):119-126. doi:10.1055/s-0034-1396079Bernstein J.Not the Last Word: Safety Alert: One in 200 Knee Replacement Patients Die Within 90 Days of Surgery.Clin Orthop Relat Res. 2017;475(2):318-323. doi:10.1007/s11999-016-5197-1Kaiser Permanente.Total Knee Replacement: What to Expect at the Hospital.NHS.Complications of a knee replacement.

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.OrthoInfo.Total knee replacement.Rodríguez-Merchán EC.The stiff total knee arthroplasty: causes, treatment modalities and results.EFORT Open Rev. 2019;4(10):602-610. doi:10.1302/2058-5241.4.180105Nam D, Barrack T, Nunley RM, Barrack RL.What is the frequency of noise generation in modern knee arthroplasty and is it associated with residual symptoms?Clinical Orthopaedics & Related Research. 2017;475(1):83-90. doi:10.1007/s11999-016-4701-yAmerican Academy of Orthopaedic Surgeons.Revision total knee replacement.American Academy of Orthopaedic Surgeons.Joint replacement infection.Shetty T, Nguyen JT, Sasaki M, et al.Risk factors for acute nerve injury after total knee arthroplasty.Muscle Nerve. 2018;57(6):946-950. doi:10.1002/mus.26045Manrique J, Gomez MM, Parvizi J.Stiffness after total knee arthroplasty.J Knee Surg. 2015;28(2):119-126. doi:10.1055/s-0034-1396079Bernstein J.Not the Last Word: Safety Alert: One in 200 Knee Replacement Patients Die Within 90 Days of Surgery.Clin Orthop Relat Res. 2017;475(2):318-323. doi:10.1007/s11999-016-5197-1Kaiser Permanente.Total Knee Replacement: What to Expect at the Hospital.NHS.Complications of a knee replacement.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

OrthoInfo.Total knee replacement.Rodríguez-Merchán EC.The stiff total knee arthroplasty: causes, treatment modalities and results.EFORT Open Rev. 2019;4(10):602-610. doi:10.1302/2058-5241.4.180105Nam D, Barrack T, Nunley RM, Barrack RL.What is the frequency of noise generation in modern knee arthroplasty and is it associated with residual symptoms?Clinical Orthopaedics & Related Research. 2017;475(1):83-90. doi:10.1007/s11999-016-4701-yAmerican Academy of Orthopaedic Surgeons.Revision total knee replacement.American Academy of Orthopaedic Surgeons.Joint replacement infection.Shetty T, Nguyen JT, Sasaki M, et al.Risk factors for acute nerve injury after total knee arthroplasty.Muscle Nerve. 2018;57(6):946-950. doi:10.1002/mus.26045Manrique J, Gomez MM, Parvizi J.Stiffness after total knee arthroplasty.J Knee Surg. 2015;28(2):119-126. doi:10.1055/s-0034-1396079Bernstein J.Not the Last Word: Safety Alert: One in 200 Knee Replacement Patients Die Within 90 Days of Surgery.Clin Orthop Relat Res. 2017;475(2):318-323. doi:10.1007/s11999-016-5197-1Kaiser Permanente.Total Knee Replacement: What to Expect at the Hospital.NHS.Complications of a knee replacement.

OrthoInfo.Total knee replacement.

Rodríguez-Merchán EC.The stiff total knee arthroplasty: causes, treatment modalities and results.EFORT Open Rev. 2019;4(10):602-610. doi:10.1302/2058-5241.4.180105

Nam D, Barrack T, Nunley RM, Barrack RL.What is the frequency of noise generation in modern knee arthroplasty and is it associated with residual symptoms?Clinical Orthopaedics & Related Research. 2017;475(1):83-90. doi:10.1007/s11999-016-4701-y

American Academy of Orthopaedic Surgeons.Revision total knee replacement.

American Academy of Orthopaedic Surgeons.Joint replacement infection.

Shetty T, Nguyen JT, Sasaki M, et al.Risk factors for acute nerve injury after total knee arthroplasty.Muscle Nerve. 2018;57(6):946-950. doi:10.1002/mus.26045

Manrique J, Gomez MM, Parvizi J.Stiffness after total knee arthroplasty.J Knee Surg. 2015;28(2):119-126. doi:10.1055/s-0034-1396079

Bernstein J.Not the Last Word: Safety Alert: One in 200 Knee Replacement Patients Die Within 90 Days of Surgery.Clin Orthop Relat Res. 2017;475(2):318-323. doi:10.1007/s11999-016-5197-1

Kaiser Permanente.Total Knee Replacement: What to Expect at the Hospital.

NHS.Complications of a knee replacement.

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