compliction of TKA.docVIP

Total knee replacement has become an acceptable method of treating severe arthritis of the knee. The operative procedure must be performed with precise skill and accuracy. Meticulous alignment of the prosthetic components can reduce many of the complications.[1] Fine attention to general operating technique with adroit handling of tissues and efficient teamwork can reduce operating time to a minimum and thus avoid exposing the wound for an inordinate amount of time. An experienced, efficient technique also aids in preventing deep venous thrombosis and unnecessary scarring and decreases many of the complications that are associated with total knee arthroplasty. An implanted knee with excellent insertion can be seen in the image below. Total knee arthroplasty. Implanted knee with excellent insertion. Complications can be classified as those specific to the operation, general complications of the anesthetic (perioperative complications), and other medical complications (postoperative complications). Perioperative complications include blood loss, infection, early hemorrhage and wound breakdown, intraoperative fractures, and anesthetic problems, as well as cardiovascular, respiratory, renal, electrolyte, and other medical problems.[2] Deep venous thrombosis is a major danger, particularly if it embolizes to the lung. Precautions are necessary with early mobilization, thromboembolic disease stockings, foot pumps, and anticoagulant therapy. Low-molecular-weight heparin is the drug of choice for prophylaxis. Administering warfarin (Coumadin) 10 mg the night prior to surgery,[3] followed by a daily dose that keeps the international normalized ratio of 1.5-2 for 8 weeks, is also satisfactory.[4] Asymptomatic deep vein thrombosis has been reported in up to 50-70% of patients who receive total knee arthroplasty. Postoperative ultrasonography or venography can reveal the presence of thrombi quite successfully. Infection is rare following total knee arthroplasty. It occurs