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The 5 Most Common Complications Of Total Knee Replacement Surgery

Today we’re going to be talking about the five most common complications after total knee replacement surgery. Many TKR surgeries go well and everything works out fine. There can occasionally be complications during the recovery process so we want to take the time to address the five most common complications, how to identify them, and the best ways to treat them so that you can get the results from your surgery that will help you get active, stay mobile, and age stronger.

If you would prefer to watch an explanation of the 5 most common complications of a total knee replacement surgery, Dr. Wong recorded this awesome video that breaks down the concerns and solutions of each complication. You can watch it here:


The first complication that we’re going to talk about is infections. When you come out of knee replacement surgery, there are a few symptoms that might tell you that you might have an infection. 

Symptoms of infection include fevers and chills, increasing redness and swelling around the knee joints, and/or increasing pain and smelly discharge from the incision site. 

The good thing about infections is that it typically is very rare.

However, if you do test positive for infections there are three main treatments that most surgeons will do to get rid of it. The methods include antibiotics, washing the joint out, or, if those two methods don’t work, the surgeon might have to go back in and do a revision replacement surgery.

Antibiotics are primarily used when the infection is only on the skin’s surface and not deep within the actual joint. If the infection is deeper within the knee joint, they might need to open up the surgical sutures and wash the joint out.

If after four to six weeks of washing the joint out the infection continues, then the surgeon might have to go back in to take out the implant and do a revision replacement surgery.

Implant Failure

The next complication is knee implant failure. This is more uncommon than infections. Nevertheless, it can still happen and sometimes the bone just doesn’t heal properly around the implant.

In this case the surgeon will have to open you up and take the implant out to replace it with a whole new implant. Most surgeons will have a follow-up six to eight weeks after your surgery to take an x-ray to make sure the bone around the joint is healing correctly and that there is no defect.

Blood Clots

The third complication after total knee replacement are blood clots. Symptoms include increase in heat and excessive swelling around the knee joint and pain, with squeezing the calf muscle on the same side that you have the surgery.

The way your doctor will diagnose the blood clot is with a doppler ultrasound.

If you do test positive for a blood clot, the doctor might change your meds or recommend some compression stockings to help some of the blood circulate better.

Long-Term Stiffness

The fourth complication after a total knee replacement is long-term knee stiffness.

When you come out of knee replacement surgery it is normal to have stiffness in the beginning, due to post-surgical pain and swelling. After six weeks, you should have at least 90 degrees of knee bending or flexion. 

If you don’t have the mobility at this point in time, your therapist should address either scar tissue or pain control.

Persistent Knee Pain

The fifth complication that many people suffer with after total knee replacement is persistent knee pain. This can be very frustrating, as most people get total knee replacement in the first place to get rid of pain and just be more functional.

Persistent knee pain can be caused by muscles and nerves around the new joint or even joints and muscles on the opposite side that are compensating because of the new knee that you currently have.

The best way to find out the root cause of your persistent knee pain is to connect with a physical therapist to get assessed. That way you can find out if it’s a muscle, nerve, joint or compensation problem and what to do about it.

Get Help With Your Recovery Before And After The Surgery

If you have any questions, please call (281) 721-4023 and our team will give you the information you need to get clarity on your specific needs and situation so that you can make the best decision for your health going forward.

At Next Level Physical Therapy we offer both prehab and rehab services so that you can go into total knee replacement surgery with less likelihood of complications, a faster recovery time, and more mobility and less pain over the course of the rehabilitation process.


Dr. Jack Wong

Next Level Physical Therapy

"We Help People Age 40+ Stay Active, Healthy & Mobile Without Relying On Pain Meds, Injections Or Surgery"