How Risky is Total Knee Replacement Surgery?

A research colleague has been pulling data from the National Inpatient Sample (NIS) Medicare database on the risks for total knee replacement as part of a publication on our use of stem cells in the knee and hip. What’s amazed both he and I is the serious side effects of knee replacement that often go unnoticed by the average person, who believes a knee replacement is just like getting a new part replaced in your car. A knee replacement, while safe in many patients carries with it serious risks and complications. As an example, in the year 2008 alone, 4,964 deaths due to knee replacement were found in this database. Even more surprising, if you add up the number of pulmonary emboli (blood clots into the lung), myocardial infarctions (heart attacks), and pneumonia’s caused by knee replacement surgery, it adds another 10,000 patients. In addition, if you extrapolate this data using a recently published large complications paper on knee replacement, there are another approximately 17,500 infections. That means in Medicare recipients alone in just one year, about 22,500 patients a year have serious, life threatening complications (some life changing like heart attack) that require significant additional hospital time and prolonged recovery. These numbers don’t include the other big spike in knee replacements which is patients in their 50’s who have group health insurance and are unlikely to be covered under the Medicare program, so the totals for the U.S. are likely higher. In summary, a knee replacement isn’t like a body shop repair. While for the right patients a knee replacement can make a significant difference in pain and function, one also needs to consider the risks.

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile