Accepting Cases

Knee Replacement Complications

Knee replacement complications can result from surgery or a faulty implant. Knee replacement loosening is one of the most serious complications. It can lead to fractures or dislocation. Infection may mean replacing the implant. In rare cases, infection can lead to amputation. Some complications can happen during knee replacement surgery or within the first few weeks after surgery. Others may not show up until years after knee replacement surgery. Almost all serious knee replacement complications require some form of revision surgery. This is when a surgeon removes a faulty implant and replaces it with a new one.

Complications after a Knee Replacement?

Did you or a loved one suffer complications after receiving a knee replacement? You may be eligible for compensation.

DePuy Attune Knee
Total Knee Replacement Complications
  1. Loosening Implant fails to bond with bone
  2. Infection Can result shortly after surgery or months later
  3. Instability and Dislocation Implant wobbles or ‘gives’ when weight is placed on it
  4. Revision Surgery Serious complications usually require surgery to repair
Medically Reviewed

Board-certified physicians medically review Drugwatch content to ensure its accuracy and quality.

Drugwatch partners with Physicians’ Review Network Inc. to enlist specialists. PRN is a nationally recognized leader in providing independent medical reviews.

Reviewer specialties include internal medicine, gastroenterology, oncology, orthopedic surgery and psychiatry.

Knee replacement complications can be serious medical problems. More serious complications need revision surgery to correct.

The American Academy of Orthopedic Surgeons (AAOS) says serious complications are rare. Fewer than one in 20 knee replacements needed another hospitalization.

Some knee implants fail at higher rates. This sometimes leads to knee replacement recalls. However, there has never been an Attune Knee implant recall to date.

A 2017 study looked at the DePuy Attune knee replacement. Researchers found it failed in two of every 15 cases they examined. But the researchers only examined 15 Attune cases.

Knee Replacement Loosening

Loosening is one of the most common total knee replacement problems. Patients usually need knee revision surgery to fix it.

Knee Replacement Loosening Symptoms
Knee Pain icon
Knee swelling icon
Knee Instability icon
Knee limited range of motion icon
Limited range of motion

There are several causes for knee replacement loosening. Infection is one of the most likely causes.

Wear and tear on knee implant parts can also cause loosening.

Complications after a Knee Replacement? Get a Free Case Review
Replay Video
Madris Tomes, former FDA program manager, discusses knee implant adverse events.

Faulty components can lead to loosening, too. DePuy Attune knee replacement lawsuits claim cement connecting the device to bone failed.

Patients reported tibial loosening with DePuy Attune knee.

People also reported loosening with Zimmer NexGen uncemented knees. They claimed screws that connected the implant to bones sometimes failed.

Complications after undergoing a knee replacement? Review My Case For Free

Infection After Knee Replacement

Infections are a leading cause of knee replacement failure. They are also a serious knee replacement surgery complication.

Doctors can sometimes treat infection with antibiotics. But in some cases, patients may need revision surgery to remove the infection.

Infection can come from bacteria living on the knee implant. Or it may enter the surgical wound during surgery.

Knee Replacement Infection Symptoms
  • Pain
  • Sudden stiffness
  • Swelling
  • Warmth, heat or redness around the knee
  • Drainage
  • Fatigue
  • Fever, chills, night sweats

Bair Hugger Devices and Knee Replacement Infection

Thousands of people blame Bair Hugger devices for knee replacement infection complications. The surgical devices stabilize patients’ body temperature during knee replacement surgery.

Studies suggest Bair Huggers stir up bacteria on operating room floors. Air currents then carry the bacteria to the open surgery site.

Bair Hugger lawsuits claim patients needed amputations to stop the infections.

Knee Replacement Rejection

Knee replacement rejection is extremely rare. People may confuse it with infection, but it is different.

Implant rejection happens when metal in the implant triggers a reaction. This can be an allergic reaction or an autoimmune reaction.

Patients who suffer implant rejection need revision surgery to remove and replace the device.

Knee Replacement Rejection Symptoms
knee pain icon
Pain spreading throughout the body
Weakness icon
fatigue icon

Bone and Knee Implant Fractures

Knee Replacement Fracture Symptoms
  • Leg appears deformed
  • Leg unable to support weight
  • Pain
  • Swelling or bruising around the fracture or knee

Knee replacement fractures can happen to both bones and knee implants.

Bone fractures can happen in the thighbone, the kneecap or the tibia (one of the two bones in the lower leg).

Device fractures can cause the knee replacement to break apart.

They usually need knee revision surgery to repair.

Instability and Dislocation

Instability is a chief reason for knee replacement revision surgery. It may account for as many as one in five revisions.
Source: The Bone and Joint Journal, Jan. 1, 2016

A 2018 editorial in The Journal of Arthroplasty said instability “remains a common and devastating complication” of knee replacement.

Instability can cause excessive wear on knee replacement parts. Instability can also cause patients to fall, resulting in further injuries including fractures.

In the worst cases, instability can cause knee dislocation.

Knee dislocation is when the knee replacement implant pops out of the joint.

Knee Replacement Instability and Dislocation Symptoms
Knee Pain icon
Knee swelling icon
Wobbly sensation knee icon
Wobbly sensation in the knee
knee weight icon
Unable to put weight on the knee

Knee Implant Misalignment and Failure

Knee replacement components have to be precisely aligned to work. If they do not line up, they can wear out too soon. Or the implant can fail without warning.

Excessive weight can increase the risk of failure if the parts are not aligned. Patients may need revision surgery to fix knee replacement misalignment problems.

Misalignment and Failure Symptoms
  • Instability
  • Pain
  • Reduced range of motion
  • Swelling
  • Warmth or heat around the knee

Surgery Complications

Knee replacement surgery shares risks with other types of surgeries. Patients should talk with their doctors about these risks before surgery.

Knee Replacement Surgery Risks
Anesthesia reactions icon
Anesthesia reactions
Blood Clots icon
Blood clots
heart attack icon
Heart attack
Stroke icon

Nerve Damage from Surgery

Knee Replacement Nerve Damage Symptoms
  • Radiating pain
  • “Tingling” sensation in leg
  • Numbness in the leg or foot

Nerve damage can happen with knee replacement surgery. It usually goes away within six months.

The AAOS says “pressure, stretching or cutting” can damage nerves.

Research suggests surgical tourniquets may put damaging pressure on nerves.

Surgeons also must cut and stretch skin and muscle during knee replacement surgery.

Nerve Block Complications

Some patients may experience knee replacement nerve block complications.

Doctors treat patients with nerve blocks to relieve pain following knee replacement surgery. Studies have found nerve blocks can sometimes delay recovery.

Knee Replacement Nerve Block Complication Symptoms
  • Slowed recovery time
  • Falling
  • Peroneal nerve palsy – affecting sensation and movement in the leg, foot and toes

Swelling and Joint Pain

When swelling and joint pain happen together, it can be a sign of infection. They may also be a sign that there is a problem with the knee implant.

Pain alone can be difficult to diagnose. It can happen with almost any other knee replacement complication.

A 2016 study found as many as two in five people experience chronic pain following knee replacement surgery.
Source: Chronic Postsurgical Pain, Feb. 21, 2016

Risk of Death After Knee Replacement

The risk of death from knee replacement is very low, but it does happen.

A 2017 study looked at leading causes of death within 90 days of knee replacement surgery. The main cause of death was ischemic heart disease (“hardening of the arteries”).

In a 2012 study, researchers in the U.K. analyzed nearly 2,500 people. All underwent total knee replacement over a 10-year span.

Researchers factored in predicted life expectancy based on age and gender. They found mortality rates were the highest in the 30 to 90 days following surgery.

The study reported survivability over 10 years. The researchers published their findings in The Bone & Joint Journal.

2012 Knee Replacement Survivability Study Findings
Patients surviving at least one year: 99%
Patients surviving at least one year.
Patients surviving at least five years: 90%
Patients surviving at least five years.
Patients surviving at least ten years.
Patients surviving at least ten years.

Clicking or Popping

Clicking or popping sounds after surgery are a normal knee replacement side effect. This is not necessarily a complication.

The noise may be from the metal or plastic parts. Or it may be tendons adjusting to the new implant.

The sounds usually decrease or even go away after several months. Clicking by itself is not a serious problem.

But patients should let their doctor know if they experience pain, swelling or other noises along with the clicking.

“Most people also feel or hear some clicking of the metal and plastic with knee bending or walking. This is a normal.”

Source: American Academy of Orthopaedic Surgeons

When Can Complications Happen?

Complications can happen immediately after knee replacement surgery. Some knee replacement complications may take years to show up. Different complications may be more likely at different times.

Knee Replacement Complication Timeline
  • During Surgery or within the First Few Weeks After Surgery
    • Nerve damage
    • Nerve block complications
    • Blood clots
  • Weeks to a Year or More After Surgery
    • Loosening
    • Infection
    • Implant rejection – allergic or immunologic reaction
    • Component misalignment or failure
    • Pain, swelling and warmth or heat in the knee
    • Loss of mobility or range of motion
  • Any Time After Knee Replacement Surgery (0 to 20 Years)
    • Instability and dislocation
    • Fractures
    • Bone loss
    • Wear and tear
    • Revision surgery

Please seek the advice of a medical professional before making health care decisions.

Did you find Drugwatch helpful?

29 Cited Research Articles

  1. J Cutan Aesthet Surg (2011, Jan-Apr). Orthopaedic Surgery in a Patient with Metal Sensitivity. Retrieved from
  2. Clement, N.D. et al. (2012, February 8). Predictors of mortality after total knee replacement. Retrieved from
  3. Levine, H. (2016, June 29). Your Risk of Infection After Knee Replacement Depends on Your Hospital. Retrieved from
  4. Consumers Union. (2013, September 9). A Summary of Knee Recalls Consumers Union Safe Patient Project. Retrieved from
  5. Witvrouw, E. et al. (2012, August 3). Manipulation under anesthesia versus low stretch device in poor range of motion after TKA. Retrieved from
  6. Greengard, S. (2015, February 20). Risks and complication of total knee replacement surgery. Retrieved from
  7. Ainscow, D.A.P. and Denham, R.A. (1984). The risk of haematogenus infection in total joint replacements. Retrieved from
  8. Moran, E. et al. (2010, November 1). The diagnosis and management of prosthetic joint infections. Retrieved from
  9. Meirer, B. (2010, June 19). Surgeon vs. knee maker: Who's rejecting whom? Retrieved from
  10. U.S. Food and Drug Administration. (2010, March 10). Enforcement report for March, 10, 2010. Retrieved from
  11. Illgren, R. (2008, August 14). What is osteolysis and what should I do about it? Retrieved from
  12. American Academy of Orthopaedic Surgeons. (2015, May). Revision Total Knee Replacement. Retrieved from
  13. American Academy of Orthopaedic Surgeons. (2015, August). Total Knee Replacement. Retrieved from
  14. Farahini, H. et al. (2012, July). Factors influencing range of motion after total knee arthroplasty. Retrieved from
  15. U.S. Food and Drug Administration. (2017, January 25). 501(k) Clearances. Retrieved from
  16. Cross, M.J. (2015, December 21). Complications of Total Knee Arthroplasty. Retrieved from:
  17. Bozic, K.J. (2013, January 29). Total Knee Replacement Risks and Complications. Retrieved from:
  18. Labek, G., et al. (2011, February 28). Revision Rates after Total Joint Replacement. Retrieved from:
  19. Arthritis Research UK. (n.d.). What Are the Possible Complications of a Knee Replacement? Retrieved from:
  20. Hunt, L.P., et al. (2014, October 18). 45-Day Mortality after 467,779 Knee Replacements for Osteoarthritis from the National Joint Registry for England and Wales: An Observational Study. Retrieved from:
  21. Han, H.S.; Kang, S.B.; and Yoon, K.S. (2007, November 11). High Incidence of Loosening of the Femoral Component in Legacy Posterior Stabilized-Flex Total Knee Replacement. Retrieved from:
  22. Consumer Reports. (2014, March 18). Artificial Hips and Knees Need a Lemon Law, Says Consumer Reports. Retrieved from:
  23. Harvard University. (n.d.). Surgical Complications Are Top Reason for Hospital Readmissions. Retrieved from:
  24. University of Michigan. (2011, May 25). What Raises the Risk of Stroke after Surgery? Retrieved from:
  25. Avramescu, S. (2010, October 22). Common Side Effects after Anesthesia. Retrieved from:
  26. Foran, J.R.H. (n.d.). Total Knee Replacement. American Academy of Orthopaedic Surgeons. Retrieved from
  27. American Academy of Orthopaedic Surgeons. (2016, August 17). Is It Normal to Hear Clicking Sounds from My Knee Replacement? AAOS YouTube Channel. Retrieved from
  28. Cluett, J. (2017, October 11). Clicking Noise from a Knee Replacement. Verywell. Retrieved from
  29. Arshi, A. et al. (2017, December 6). Outpatient Total Knee Arthroplasty Is Associated with Higher Risk of Perioperative Complications. The Journal of Bone and Joint Surgery. Retrieved from:
View All Sources
Who Am I Calling?

Calling this number connects you with Wilson and Peterson, LLP or one of its trusted legal partners. A law firm representative will review your case for free.

Wilson and Peterson, LLP funds Drugwatch because it supports the organization’s mission to keep people safe from dangerous drugs and medical devices.

(855) 595-3160

To contact Drugwatch Managing Editor Kevin Connolly, call (855) 839-9780.