Guide to Knee Surgery
What are the Risks of Knee Surgery ?
While the success rate from knee surgery is very high, there is always risks. With some operations, such as knee replacement, the risks are greater than other simpler procedures, such as knee arthroscopy. Some common complications include:
In all forms of knee surgery, we use some form of blood clot prevention measures. These measures do decrease the risk of blood clots in the leg and lungs, but they cannot totally remove any risk. Hence, there is an exceptionally low but unfortunately very real risk of a blood clot in the lungs that is so severe; it can place your life at risk. Blood clots below the knee are quite common and usually harmless, but the rarer blood clot above the knee is more concerning as it can break off and enter the lungs. Its important to avoid long periods immobilization just before and after the surgery.
After any surgery some patients can suffer from a stiff knee joint with lack of bend or ability to straightening. Occasionally it is necessary in these patients to take them back to theatre if physiotherapy fails to improve the situation. It may be just a simple manipulation of the knee under a GA, but in some situations, the knee may need to be opened or examined arthroscopically. It is more common with knee replacements, reconstructions and osteotomies.
Medical Device Problems
If you are having a knee replacement, ligament reconstruction or osteotomy, you must understand that prosthetic devices are used in the knee. Occasionally these can come loose or move position and they may need to be corrected or removed by subsequent surgery. In the case of knee ligament reconstruction or osteotomy, this typically does not degrade the long-term outcome of the surgery. In the case of total knee replacement, however, it can affect the longer-term outcome of the knee replacement and revision surgery of the knee replacement may be necessary.
The surgeons at Orthopaedic Surgery and Sports Medicine Centre do their utmost to make skin incisions appear cosmetically appealing and as small as possible. Most incisions heal as a fine white line. Occasionally, patient’s notice altered sensation in the area of the skin incision, which disappears with time. Unfortunately, a small percentage of patients do suffer continual pins and needles sensation around the incision. This does not tend to decrease the outcome of the surgery but it is annoying for patients.
Surgery of the knee can occasionally result in injury to some of the small nerves that run past the knee. Some of these control muscles in the ankle and some of these supply the sense of feeling in the legs. If one of these nerves around the knee is injured or function is interrupted, the usual situation is that with observation, the nerve recovers. Occasionally, despite best efforts, the nerve function does not return. The risk of this happening is greatest in surgeries around the knee to repair menisci or during complex ligament reconstruction, such as posterior cruciate ligament reconstructions. It also is possible after knee replacement surgery but is extremely rare after knee arthroscopy.
In general, the risk of infection with knee surgery is relatively low and ranges from 1 in 200 to 1 in 1,000, depending on the extent
Things to Consider
Before your surgery
Discuss fully with Dr Vertullo your expectations & concerns- not everybody will get the same final result. Only decide to proceed if you understand the process, the risks and outcomes. If your are overweight, a pre-op diet will reduce the risks of surgery. You may be referred to a physician, Dr Clark,to have a pre-surgery check up. Avoid long airplane flights prior to the surgery to decrease your blood clot risk. Ride an exercise bike daily in the weeks prior to surgery.
Whilst in Hospital
Be involved in your physio and pain medication decisions. Pain control is essential to achieve a good outcome. It is important to work with the physio . It is vital not to fall over after surgery, so take care. Most pain relief can causes constipation, so ask for laxatives if needed.
Pain control is important. Once your home, make sure you are not going to run out of pain medication- think ahead. If you experience increasing pain, swelling or wound redness etc, notify Dr Vertullo ASAP.
Recovery depends on what type of procedure you are going to have.