Surgical Risk Factors | Knee

As with all surgical procedures, there can be complications. Infection, pneumonia, and blood clots are some of the possible, although unlikely, complications that can occur.

Infection

Infection occurs in 5 our of 1000 patients (0.5%).

Prevention:

  • Use of a special sterile operating room environment.
  • Use of pre-operative antibiotics.
  • Use of antibiotics when undergoing future dental work or surgical procedures.

Treatment:

  • Antibiotics.
  • Removal of the prosthesis and six weeks of antibiotics before the prosthesis is reinserted.

Bleeding

As with any surgical procedure, hip or knee replacement surgery may be associated with bleeding during the procedure. In most cases, the blood loss during surgery is well tolerated by the patient and requires no intervention. In some cases, the blood loss may cause the patient to become anemic, resulting in fatigue and a rapid heart rate. In some cases, this may require a blood transfusion to improve the symptoms and is typically well tolerated by the patient. There are risks associated with blood transfusions including a transfusion reaction or transmission of communicable diseases; however, these occur very rarely.

Blood Clots (Deep Vein Thrombosis or Pulmonary Embolism)

Blood clots in the deep veins of the leg (thrombophlebitis) occur in less than 5 out of 100 patients (5%).

Prevention:

  • Support hose.
  • Walking as soon as possible after surgery.
  • Pre- and post-perative blood thinning medicine if you have had a blood clot before.
  • One aspirin a day after surgery.
  • Ankle pump excercises.
  • Ensuring that you do not ride in a car longer than 45 minutes without stopping to stretch and walk.

Treatment:

  • Observation.
  • Not sitting in certain positions.
  • Heating pad.
  • Blood thinning medicine.
  • Elevation of legs in bed.

Blood clots that occur in the thigh or pelvis may break loose and travel to the lungs where they can cause breathing difficulty or death.

Treatment:

Requires hospitalization.

Nerve Injury

Nerve damage may occur in 10 out of 10,000 patients (.10%). This is observed as a complaint of numbness or weakness in the foot.

Prevention:

  • Frequent circulation checks by nurses.
  • Frequent changes in position.

Treatment:

With time, these nerves will usually improve. Some nerve damage, however, may be permanent.

Dislocation

Dislocation occurs when the ball comes out of the socket. It occurs in 1-2% of hip replacements. The risk is highest in the first two months after surgery.

Prevention:

Follow the restrictions listed in Chapter 14 and at the back of the book.

Treatment:

The orthopedic surgeon puts the ball back in the socket. This may require anesthesia, but usually no incision is necessary. Frequent dislocations may require a brace, casting, or even surgery.

Leg Length Inequality

There is the possibility that your operated leg will be shorter or longer than your unoperated leg. The surgeon is usually able to make the legs the same length; however, there is a 1-3% possibility that your leg may be shorter or longer by as much as �" in order to properly balance the hip and decrease the likelihood of dislocation.

Implant Loosening

Loosening of the prosthesis occurs in 2-3% of our patients over a 10-year period of time.

Prevention:

  • Maintain ideal body weight.
  • Follow restrictions listed in Chapter 14.

Treatment:

Will probably require revision surgery at some time.