How safe is total knee replacement surgery?
The doctor has recommended my father for a TKR. I would like to know how safe the TKR op is?
This is a common question who is asked by everybody suffering from severe osteoarthritis of the knees.
Total knee replacement surgery is very safe, and the success rate is well over 97-98%. But of course, like any other surgery, there are several potential risks that I will always highlight to my patients.
1. Infection (< 1%) : I’d say this is the ONE complication that is beyond the control of the surgeon. Despite the advancement in medical technology, bacteria remains to be our top enemy to our health. Fortunately, the risk of deep infection is very low (< 1%) which is the international standard for all reputable joint replacement centres in the world.
2. Neurovascular injury (injury to the nerve or the blood vessels, < 1%): This is the most dreaded complication. However, with proper protection and meticulous surgical technique, the risk of such complication can be even lower than 1% in experienced hands. With the help of the robot, which has a mechanism to protect the nerve and the blood vessels, we aim to bring down such complications to ZERO.
3. Anaesthesia risk (<1% if you are healthy and not suffering from any major problems with the hearts/ lungs/ kidneys/ stroke): Total knee replacement is not a small procedure that can be done under local anaesthesia. It can be safely done under either Spinal Anaesthesia (half body anaesthesia) or General Anaesthesia (full body anaesthesia). We will check your heart (ECG), your lungs (Chest X rays) and perform blood tests to ensure your fitness for operation. Rest assured that the safety of our knee replacement patients is our top priority.
4. Deep vein thrombosis (DVT)/ Pulmonary Embolism (PE) (<0.5%): DVT (aka Economical class syndrome) happens when the blood flow out of the lower limb is slow and sluggish, such as prolonged sitting in a very cramped long haul flights or after lower limb surgeries such as total knee replacement.
It will be dangerous if the blood clot is dislodged and clogged up the lungs vessels (Pulmonary Embolism). But rest assured that we have multiple methods to prevent such complications: blood thinning medication, mechanical foot pumps to promote blood flow.
The best prevention is early walking exercises (the natural way to promote blood flow) after surgery. We have advanced pain killing techniques that allow our patients to walk even on the same afternoon after a total knee replacement surgery.
In conlusion, I'd say that total knee replacement surgery is not a small procedure. Comparatively, it's not as risky as those open heart/ open brain surgeries. If done under experienced hands, the success rate is well above 97-98%.
Almost all of my own patients will be able to walk around independently, pain free within 3 months. I hope this will give you some reassurance if you are exploring about the knee replacement surgery as a treatment option for your knee osteoarthritis.
Read this article to find out everything you need to know about knee replacements in Singapore.