Total knee replacement surgery is considered major surgery, but every precaution is taken to make the procedure as safe as possible. As with any surgical procedure, there are risks with being placed under anesthesia. You will meet the anesthesiologist taking care of you prior to the surgery and be able to discuss the specific risks of anesthesia.
Bleeding is an expected risk of surgery, as your bone is a vascular structure. Cutting the bone, removing bone spurs, and inserting an implant will cause blood loss. Since a tourniquet is used during surgery, the blood loss often occurs after surgery. Dr. Su uses special techniques to reduce blood loss, minimizing your risk of transfusion. Certain patients will still need a blood transfusion after surgery, particularly if you are anemic, or are having both knees replaced. If you believe you may need a blood transfusion after surgery, you can pre-donate your own blood so that you can receive it after surgery.
There is a risk of formation of blood clots after total knee replacement surgery, so it is necessary that you use a blood thinner. Generally, these medications are used temporarily after surgery, to protect you from dangerous blood clots. In addition, moving around during your recovery, as soon as possible, will help decrease the risk of clots.
Infection is always a risk when an implant is involved. An infection can occur immediately after surgery, or years after the surgery. Infection rates are lowest at hospitals that perform the most surgery; Hospital for Special Surgery has performed more knee replacement surgeries than any other hospital in the world. After your recovery, it is also important to let your health care providers know that you have an artificial knee, so that you can take precautions to prevent late infections. You should make certain your dentist knows that you have an implant, because you will have to take antibiotics prior to any dental work.
The knee is prone to scar tissue formation after surgery, particularly if you are immobilized. It is essential that you begin bending and extending your knee immediately after surgery. This will help minimize the formation of scar tissue; if you do not bend or extend your knee sufficiently by the time of your first postoperative visit, you may need an outpatient procedure called a manipulation, in order to break up scar tissue. If you are unable to achieve full motion, you will have difficulty walking and negotiating stairs.
A knee implant is our best method of treating severe arthritis; however, it is an artificial joint, and cannot completely recreate the natural knee joint. Therefore, there can be the sensation that the knee implant does not feel like one’s own knee; also, on occasion, there can still be pain around a total knee replacement.
It is common that there will be residual numbness on the outside of the skin incision. At times it will diminish over the course of recovery; other times, it may be permanent. Generally, this does not bother patients nor limit them.
Despite these risks, total knee replacement is generally very successful and these complications can all be managed.