The results after knee arthroplasty are usually good or very good, with an implant survival rate of around 85-90% at 20 years. Complications, although very rare, can occur; the most common are:

  • Skin or wound complications: Preoperative planning, the surgical technique itself, and good postoperative management are essential to avoid soft tissue complications, especially in high-risk patients and those with previous knee surgeries.
  • Infection: Deep infection is one of the most serious complications; infection rates vary between 1% and 2%.

Treating this complication presents a challenge for the orthopedic surgeon, as it is very difficult and lengthy. A thorough understanding of the risk factors is essential for proper prevention and management of the problem.

  • Deep vein thrombosis: Venous thrombosis remains one of the most serious complications following hip or knee arthroplasty surgery and is a leading cause of hospital readmission. Strategies to reduce its incidence range from recognizing risk factors and prophylactic heparin treatment to general patient care, the use of regional anesthesia, and early mobilization.
  • Patellar Complications: Patellar complications vary between 1% and 10%. Patellar pain after total knee replacement (TKR) can result from the prosthetic design, the surgical technique, or failure to properly reinforce the patella. Symptoms of patellar clicking include pain and an audible sound when the knee is extended between 60° and 30° of flexion.
  • Postoperative Stiffness: Knee stiffness or arthrofibrosis is related to multiple factors such as poor joint mobility after surgery, patient characteristics, range of motion before surgery, prosthetic design, surgical technique, or postoperative rehabilitation.
  • Persistent Pain and Dissatisfaction: Persistent pain in the anterior aspect is a frequent complaint after a total knee replacement; several studies estimate the number of dissatisfied patients after a knee arthroplasty to be between 13-19% of cases.