Common complications during knee replacement recovery

1. What the evidence collectively asserts about post‑op problems and why it matters

Multiple sources converge on the same core claim: knee arthroplasty recovery is commonly complicated by stiffness, pain, infection, thromboembolism, and implant‑related problems, with additional events ranging from wound complications to neurological deficits. The Knee Society’s standardized list catalogs over 20 possible adverse events, reinforcing that the spectrum is broad and not limited to short‑term pain ^[1]. Clinical overviews and hospital materials reiterate that complication profiles depend on procedural choices (total vs partial), surgical technique, and perioperative care, making the concept of “common complications” both clinically meaningful and actionable for planning discharge, prophylaxis, and follow‑up ^{[5] [6]}.

2. How frequent are these complications and which patients are most vulnerable

Reported complication rates vary by age and study design: one synthesis cites complication rates of roughly 7.1% in patients under 80 and 34.3% in those over 80, highlighting age as a dominant risk modifier ^[2]. Comorbidities such as obesity, diabetes, cardiovascular disease, and prior joint deformity increase the likelihood of infection, delayed healing, and prosthetic loosening; anticoagulation strategies and mobility restrictions influence thromboembolism risk. Hospital and health‑system guides emphasize that a patient’s baseline function and adherence to rehabilitation predict functional outcomes and complication incidence, which is why preoperative optimization and shared decision‑making are central to modern practice ^{[3] [4]}.

3. What clinicians identify as the most frequent, preventable problems

Health systems and specialty reviews single out arthrofibrosis (stiffness) as the most common functional complication, driven by scar tissue, inflammation, and delayed or insufficient rehabilitation; early physical therapy and home exercises are repeatedly emphasized as critical preventive measures ^[3]. Surgical site infection and DVT are the most serious potentially preventable complications—managed through perioperative antibiotics, sterile technique, early mobilization, and anticoagulation protocols—while persistent pain or instability may reflect implant alignment or soft‑tissue balance issues requiring specialist assessment ^{[4] [5] [7]}.

4. Proven strategies to reduce harm and improve recovery timelines

Consensus sources stress a multilayered prevention bundle: preoperative optimization, intraoperative precision, and postoperative protocols including antibiotics, thromboprophylaxis, multimodal pain control, and regimented physical therapy. Typical recovery trajectories cited range from reduced pain and resumed daily activities by three to six weeks, with full recovery spanning four months to a year; adherence to therapy shortens stiffness risk and supports implant function ^{[4] [8]}. When early conservative measures fail, advanced interventions—manipulation under anesthesia, targeted revision, or infection debridement—are evidence‑based next steps referenced across surgical literature ^{[3] [5]}.

5. Where guidance diverges, what's missing, and what patients should specifically ask

Sources differ in emphasis: hospital patient guides prioritize early mobility and behavioral mistakes to avoid (overexertion or stopping exercises), specialty literature emphasizes precise surgical technique and implant choices, and standardized complication lists catalogue rarer events for surveillance ^{[8] [5] [1]}. Gaps include variable reporting of complication rates across age cohorts and limited uniformity in outcome timelines, which complicates patient expectations. Patients should explicitly ask surgeons about individualized risk estimates, thromboprophylaxis plans, infection prevention steps, expected functional milestones, and escalation pathways for persistent swelling, fever, worsening pain, or breathing difficulties—signs that require immediate evaluation ^{[2] [4] [6]}.