Orthopedic Surgery Expert Witness Comments on Total Knee Replacement

This case involves a sixty-five-year-old male patient who sustained work-related injuries to his right knee. After receiving conservative therapy, the patient underwent arthroscopy and finally a total knee replacement due to painful arthritis. Following the procedure, the patient had complaints of pain and a significantly decreased range of motion compared to before the replacement. X-rays that were taken postoperatively revealed that the patella had not been resurfaced and a revision of the right knee with a downsizing of the prosthesis and recutting of the proximal tibia was recommended. There was some improvement following the revision procedure, however, the patient suffered constant pain in the limb as a result of muscle damage. The substance of the claim was that the prosthetics device utilized by the surgeon during the procedure was improperly sized and that the total knee replacement ultimately failed due to surgical error.

Question(s) For Expert Witness

1. What are the most common complications of total knee replacement surgery?

Expert Witness Response E-006295

Although knee replacement is a major procedure, it is performed very commonly and complications are rare, overall. Infection is a possible complication of any surgical procedure, yet it is fairly uncommon after knee replacement (< 2%). Blood clots in the legs are also possible complications, but if they occur, medical treatment is very successful. Dislocation of the knee is also a possible complication, yet modern knee replacement prostheses and excellent surgical technique minimizes this possibility. Most (90%-95%) knee replacements last 10-15 years, and some last even longer. Loosening of the component, which requires a revision procedure, may occur later in the life of the original implant.