Orthopaedic Surgeon

Consultations:

Randwick: 02 9399-5333

Concord: 02 9744-2666

Complications

Any surgical procedure has a risk of complications. These are rare, however they can occur. Every precaution is taken to minimise the risk. Complications can be related to the anaesthetic, general in nature; and can happen with any surgery or be specific to a particular procedure.This list is not exhaustive and does not replace a detailed discussion with me about the operation you are about to undergo. Please ask me any questions that you feel are relevant to you. Please discuss your concerns with me regarding any queries you have.

Surgical Complications   

Excessive swelling and bruising of the leg This is due to bleeding in the joint and surrounding tissues. It can cause short term pain and make it difficult to bend the knee. To avoid this, ice the leg and elevate it as much as possible for the first week or so. In this procedure a drain is generally not used as it may damage the graft in certain areas of the knee.

Bleeding

Small amounts of bleeding in the joint are normal. Large amounts of bleeding can occur but are more common in patients with bleeding disorders or those taking anti-inflammatory medications. These should be ceased 2 weeks prior to surgery. Excessive bleeding can require aspiration of the knee (using a syringe and needle to drain the fluid out) or occasionally a repeat arthroscopy to wash the fluid out.

Infection

Infection is rare after surgery but can occur. You will be given antibiotics to reduce the risk of infection. Treatment of an infection involves either tablet (oral) or drip (intravenous) antibiotics and may involve further operations to wash out the joint. Occasionally this can lead to joint stiffness, destruction of the normal cartilage within the joint or failure of the graft.

Ongoing Pain

This can be unpredictable but is more common in knees with more severe initial damage. If pain does continue then another arthroscopy may be recommended. This procedure if performed is usually to shave part of the graft which may be sitting too proud or has partially lifted off.

Joint Stiffness

Joint stiffness can result from scar tissue within the joint resulting in loss of motion. Treatment consists of physiotherapy or occasionally further surgical procedures. Full range of motion can not always be guaranteed.

Damage to Nerves or Vessels

There are small nerves under the skin which cannot be avoided and cutting them can lead to areas of numbness in the skin below or around the knee. This numbness generally reduces in size with time and doesn’t cause any functional disability. You can get also get areas of hypersensitivity or tingling around the scars. This usually settles with time and scar massage.

Anterior Knee Pain

Some patients develop pain around the kneecap. This is a result of muscle wasting and inactivity following surgery and usually resolves over time with appropriate physiotherapy and a conscientious exercise programme continued at home.

Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome)

This is a rare condition, the mechanism of which is not fully understood. It involves an overactivity of the nerves in the leg causing unexplained and excessive pain which can go on for many months and may never settle fully. Treatment involves physiotherapy, medications and review at a pain clinic.

Deep Venous Thrombosis

This condition is caused by clots in the leg which may require medical management in the form of injections or tablets to thin the blood. Very rarely these can travel to the lungs (pulmonary embolus) causing respiratory difficulties or even be life threatening.

Allergic Reactions

Allergic reactions to medications or materials used in the operating room.

Wound Breakdown

This occurs when small areas of the wound may not heal and may need to e resutured. This can sometimes result from reaction to the sutures just under the skin.

Instrument Breakage

Unsightly or Thickened Scar

Pressure

Pressure on areas of the body in the operating theatre causing nerve damage.

Diathermy Burns

Burns from cautery device used in most open operations (very rare).

Limp

Limp can occur from muscle weakness.

Any medical complication you have heard about can occur especially if you already have a pre-existing medical problem. Such complications include heart attack, stroke, kidney failure, pneumonia, bowel obstruction, bladder infection or obstruction etc. Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation or rarely death.