Knee Info
Knee Procedures

General Information

Based on the nature of your knee condition, your surgeon may recommend an operation. Your surgeon will discuss all aspects of the operation with you and will answer any questions that you have. In addition, we have provided the information below to help you fully understand your particular operation.

If you are considering having any knee operation, you must read the section General Information about Knee Surgery.

You can view the information for each operation online or download a brochure.

At Sydney Knee Specialists, we aim to give you as much information as possible about your knee condition and your treatment options. Only then can you make an informed decision with regard to any treatment, including surgery.

Complications

Knee surgery is complex, and unfortunately, complications can occur despite all due care being taken by SKS’s health professionals and our patients.

The following information is to provide a clear picture of the reasons for some complications and how to deal with them.

Complications can be related to the anaesthetic or to the surgery. Please also see our information related to your specific procedure.

Anaesthetic Related Complications

All surgical operations require some form of anaesthetic. This may be a general anaesthetic (when you are put to sleep) or a regional anaesthetic (nerve or spinal blocks using local anaesthetic). Your type of anaesthetic will be discussed with you by our anaethetist prior to your surgery.

Uncommonly, some patients have allergic reactions to drugs that they have been given. During or soon after an operation, patients can suffer a stroke, heart attack, abnormal heart beats (arrhythmia) or inhale vomit that can cause damage to the lungs. These are also uncommon.

Complications will be treated if they occur and may require the involvement of other specialists (eg. a cardiologist). To minimize the risk of these complications occurring, we may require you to see a medical specialist prior to surgery.

Common Surgical Related Complications

These include:

  • Joint stiffness and swelling
  • Muscle wastingInfection
  • Deep Venous Thrombosis (DVT or blood clots in your legs)
  • Pulmonary Emboli (blood clots that travel to your lungs)
  • Damage to nerves and arteries

Joint Swelling, Stiffness and Muscle Wasting

Some degree of swelling is inevitable following knee surgery. This is often related to the complexity and duration of your surgery. The vast majority of the swelling subsides within a few weeks of surgery but a small amount of swelling can persist for a few months.

It is important to rest and regularly ice the knee for the first week after surgery to aid in reduction of the swelling.

Joint stiffness is related to knee swelling. As the swelling subsides, the stiffness usually improves.

Muscle wasting (a decrease in the strength and size of muscles) is also inevitable following knee surgery. The extent of muscle wasting is also dependant upon the complexity and duration of your surgery. The amount of physiotherapy that you have received prior to surgery will play an important role in restoring muscle strength. The degree of wasting can be minimized by rapid and intensive physiotherapy to rehabilitate your muscles following surgery.

Infection

Infection is a very uncommon complication following elective knee surgery. In our practice the incidence is less than 1%. Despite all our preventative measures, however, an infection may still occur.

Infections are most commonly caused by bacteria that gain access to the wound at the time of surgery. They can also occur after surgery if there have been problems with wound healing.

If an infection occurs only around the skin incision (superficial infection) and not inside your knee joint, this usually resolves with a course of antibiotics. If antibiotic tablets do not control the infection, you may require admission to hospital to receive the antibiotics via a drip directly into your bloodstream.

If an infection occurs inside the knee joint (deep infection), this is a major concern. You will require admission to hospital and will undergo further surgery in an attempt to eradicate the infection. Sometimes multiple surgeries are required. You will require an extended duration of antibiotics both via a drip and in tablet form. This complication is uncommon, but may severely compromise the outcome of your surgery.

Deep Venous Thrombosis (DVT)

A DVT is a clot in a vein in your leg. These clots can occur in any situation when the blood flow through the veins is slowed; traveling long distances on an airplane for example.

When you have knee surgery, the blood flow in your leg veins is also slowed. One reason for this is that we often require the use of a tourniquet (inflated band) around your thigh to stop bleeding during the operation. This causes a temporary reduction in blood flow through the limb which can sometimes result in the formation of a clot usually in your calf.

We take many steps to minimize the risk of blood clots occurring during and after your surgery. Whenever possible we restrict the use of a tourniquet. If undergoing major knee surgery we give you blood thinning medication daily in the form of injections after your procedure. Your legs are placed in special stockings (TEDS) or a pneumatic compression device to assist the circulation in your legs.

In every instance we attempt to get you back on your feet and mobile as soon as safely possible after your surgery. Blood clots can cause pain and swelling in your calf. It is important to notify your surgeon of these symptoms so that the appropriate investigations can be organized. Depending on the size and location of the clot you may be required to take blood thinning tablets (eg warfarin) to prevent the clot from enlarging.

Pulmonary Emboli

Pulmonary Emboli occur when clots that form in your legs dislodge and travel to your lungs. This is an uncommon but potentially life threatening complication. Should it occur, you may require admission to hospital and be placed on blood thinning medication for approximately 6 months.

Damage to Arteries and Nerves

The skin nerves that lie on the front of the knee can be damaged from the incisions used to gain access to the knee. A patch of numbness on the front of the knee is very common after knee replacement surgery. Usually this decreases in size over two years but most often a small patch of numbness persists. Rarely,damage to the skin nerves can cause a painful scar.

A number of major arteries, veins and nerves lie in the back of the knee. It is very uncommon to cause damage to the structures in the back of the knee. If an injury to the blood vessels (arteries and veins) occurs you may require surgery by a vascular surgeon to control the bleeding and to repair the damage.

If an injury occurs to the large nerve located at the back of the knee this may cause weakness or loss of function to some of the muscles in the leg. This may be temporary or permanent.

Knee Procedures