According to research, up to one-third of patients who have had knee replacement surgery experience long-term chronic pain after surgery and one in five are dissatisfied with the results.

In the United States, total knee replacement surgery is one of the most common elective surgical procedures. There are over 600,000 total knee replacements each year.

Over 95 percent of total knee replacements in the United States are performed for osteoarthritis.

The replacement is normally conducted if the patient experiences chronic knee pain and inability to move from one place to another. Apart from osteoarthritis, knee complications can also result from avascular necrosis, bone dysplasia, rheumatoid arthritis, and gout.

During the surgery, a diseased, damaged or worn knee joint is replaced by an artificial one. The artificial replacement is normally composed of plastic, metal, and ceramic.

The surgery is usually recommended only when other forms of treatment fail. Orthopedic doctors should recommend non-surgical treatment options before surgery. While they often do, there are some alternative treatment options that most orthopedic doctors are not familiar with.

Non-surgical treatment options are discussed further in our recent article, Knee Replacement Surgery Alternatives for Chronic Knee Pain.

Knee replacement surgery has several risks and complications. Sometimes the risks of knee replacement surgery may threaten one’s life. Therefore, patients are urged to consider other alternatives before settling for knee replacement surgery. Below are some of the risks of knee replacement surgery.

Knee Replacement Surgery Risks

With a knee replacement procedure, anesthesia is necessary. Patients can either be given general or regional anesthesia. The former knocks one out until the end of surgery, regional anesthesia, on the other hand, numbs specific region while the patient is awake. Even though it is important in relieving pain, anesthesia has side effects. Below are some of the risks resulting from general and local anesthesia.

General Anesthesia

This type of anesthesia is given to patients so that they become unconscious, commonly termed as “put to sleep”. The risks of knee surgery from general anesthesia include nausea, sore throat drowsiness, and headaches (source). Additionally, there are minor risks of pneumonia, heart attack, clotting of blood and strokes. The chances of experiencing complications related to general anesthesia increases if a patient has other conditions like lung disease or heart problems.

Local Anesthesia

There are two types of local anesthesia. The first one is epidural and spinal anesthesia while the other is called peripheral nerve blocks. As with general anesthesia, partial anesthesia has some risks. They include headaches, allergic reactions, nerve injuries, and urination difficulties.

Blood Clotting

Clotting is among the major risks of knee replacement surgery. Blood clotting commonly occurs as a result of damaged blood vessels or lack of patient’s mobility for a while after surgery. Blood clotting results within the leg leads to deep vein thrombosis (DVT). Furthermore, if the blood clot breaks free, it can find its way up into the lungs and block blood flow through the body. If the blockage is not treated in time, it may lead to a condition called pulmonary embolism. This condition is lethal and patients are advised to seek early treatment. Anti-clotting medicine is the remedy for pulmonary embolism. To prevent clot formation, patients are urged to engage in regular movement of limbs as well as wear compressing devices.


Bleeding is among the risks of knee replacement surgery. However, it is a common occurrence in surgical procedures in general. It becomes an issue especially in incidences where a patient loses a lot of blood to a point that transfusion is required. After the procedure, there is a risk of excessive bleeding.

Post-Surgery Swelling and Pain

Patients may experience pain and swelling. These symptoms are among the risks of knee replacement surgery. The most common areas of the body that may swell after surgery include knees, ankles, and feet.

However, doctors provide painkillers for the pain and follow-up treatment if pain persists. On the other hand, swelling can be reduced by light exercises and applying ice on the area.

Arterial and Nerve Damage

The surgical procedure may result in cutting off blood vessels or nerves close to the knee. This is one of the risks of knee replacement surgery. To repair the affected nerve or vessel, the surgeon will have to conduct another surgery. A more severe effect of such an accident includes paralysis of the damaged region.

Other risks of knee replacement surgery include breathing difficulties, failure of the artificial joint, and allergic reaction among others.

Recovery Time

It may take up to six weeks for most patients to resume normal daily activities within 6 weeks and between three to six weeks to drive. Full recovery may take anywhere from four to six months and sometimes up to an entire year to fully recover. This recovery time is difficult for any patient to endure.

Severe Allergic Reaction

Recently, a patient visited one of our clinics and told us about an outcome she had that is not often discussed. A few years prior she had a knee replacement surgery. After a relatively short period of time, she started experiencing pain in her leg. She told us the pain was “at times so bad I couldn’t stand it.” Then, her foot turned black.

The orthopedic surgeon who performed the surgery could not figure out what the problem was.

When she got a second opinion another doctor suggested a metal allergy test. The test showed she was allergic to the nickel in the artificial knee. The metal allergy test cost her about $400 out of pocket. She was told by this doctor that since insurance doesn’t cover it, orthopedic doctors don’t usually do the test before knee replacement surgery. She did not know she was allergic to nickel and the surgeon did not suggest getting the metal allergy test.

Now, her only option was to get the nickel knee replaced with another knee made with a different material. Because of the infection, she would need to have two separate surgeries. So, instead of one knee replacement surgery, she was going to have to have three total surgeries.

Revision knee replacement surgery is more complex and more susceptible to complications than initial surgery. This all could have been avoided with a metal allergy test. She would have gladly paid the $400 to get the test prior to surgery.

Final Thoughts

It is clear that the risks of knee replacement surgery are more than a few. Even though the procedure can be successful, these risks may lead to serious health issues. Therefore, before making that decision, it is prudent to consider alternatives treatments for pain and stiffness.

Read our recent article, Knee Replacement Surgery Alternatives for Chronic Knee Pain, for more information about non-surgical treatment options.

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