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Knee Joint Replacement (cont.)

What Are Complications and Side Effects of a Total Knee Joint Replacement?

The most common problems with a knee joint replacement are

  • fractures (breaks) of the new knee after a fall or other accident,
  • pain from slippage and wear in the new joint, and
  • loosening of the prosthetic components.

Other less common problems include

  • infection of the joint;
  • dislocation, either complete or partial, of the new knee; and
  • a blood clot in a vein (deep vein thrombosis) above or below the knee. (Clots occur most commonly shortly after replacement surgery.)

Many people who fall after having a knee replacement break the bone below the new joint on which the new knee is anchored. Pain and swelling occur at or near the site of the knee joint replacement.

Pain can occur gradually as the new joint develops wear patterns that interfere with the smooth function of the knee.

  • Slippage can cause the prosthetic surfaces to move in opposition to each other and cause pain.
  • This pain increases with activity and decreases when you sit.
  • This pain of movement differs from the normal start-up pain that occurs in the first three to six months after knee replacement and that decreases over the first few steps.
  • Infection will cause pain, along with frequent redness and swelling at the joint, even when you are at rest.
  • Often fluid will collect at the knee joint in the presence of infection and cause a boggy swelling. Fluid may not accumulate with every infection.
  • Fever may occur.

Dislocating the knee will cause pain.

  • Deformity of the joint will be present.
  • A dislocation may damage adjoining nerves, muscles, and blood vessels and impair their function. The popliteal artery, which carries the entire blood supply to your lower leg and foot, can be injured or pinched shut. This is a medical emergency and requires urgent evaluation and diagnosis. The symptoms are pain, the lower leg may turn pale and cold, have poor or no pulse, and the leg may swell.
  • Nerves to your lower leg can be cut or injured, causing your lower leg to become numb (paresthesia), weak (paresis), or paralyzed.
  • Blood clots tend to form during the period ("post-op" or "post-operatively") when you cannot move following a knee replacement.
    • Clots become progressively less common with time.
    • A clot in your vein generally causes new pain, swelling, or redness in your lower leg.
    • The greatest concern is that the clot will travel through your veins and could lodge in your lung (pulmonary embolism).
Last Reviewed 11/20/2017

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