Clinical Orthopaedics and Related Research®

, Volume 471, Issue 1, pp 215–220 | Cite as

Complications of Total Knee Arthroplasty: Standardized List and Definitions of The Knee Society

  • William L. HealyEmail author
  • Craig J. Della Valle
  • Richard Iorio
  • Keith R. Berend
  • Fred D. Cushner
  • David F. Dalury
  • Jess H. Lonner
Symposium: Papers Presented at the Annual Meetings of the Knee Society



Despite the importance of complications in evaluating patient outcomes after TKA, definitions of TKA complications are not standardized. Different investigators report different complications with different definitions when reporting outcomes of TKA.


We developed a standardized list and definitions of complications and adverse events associated with TKA.


In 2009, The Knee Society appointed a TKA Complications Workgroup that surveyed the orthopaedic literature and proposed a list of TKA complications and adverse events with definitions. An expert opinion survey of members of The Knee Society was used to test the applicability and reasonableness of the proposed TKA complications. For each complication, members of The Knee Society were asked “Do you agree with the inclusion of this complication as among the minimum necessary for reporting outcomes of knee arthroplasty?” and “Do you agree with this definition?”


One hundred two clinical members (100%) of The Knee Society responded to the survey. All proposed complications and definitions were endorsed by the members, and 678 suggestions were incorporated into the final work product. The 22 TKA complications and adverse events include bleeding, wound complication, thromboembolic disease, neural deficit, vascular injury, medial collateral ligament injury, instability, malalignment, stiffness, deep joint infection, fracture, extensor mechanism disruption, patellofemoral dislocation, tibiofemoral dislocation, bearing surface wear, osteolysis, implant loosening, implant fracture/tibial insert dissociation, reoperation, revision, readmission, and death.


We identified 22 complications and adverse events that we believe are important for reporting outcomes of TKA. Acceptance and utilization of these standardized TKA complications may improve evaluation and reporting of TKA outcomes.


Knee Society Score Periprosthetic Joint Infection Public Reporting Oxford Knee Score Standardize List 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank John Garfi, MS, EMT, Lahey Clinic Medical Center, who assisted with the preparation of the manuscript, and Mario Moric, MS, Rush University Medical Center, who assisted with the statistical evaluation.


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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • William L. Healy
    • 1
    Email author
  • Craig J. Della Valle
    • 2
  • Richard Iorio
    • 1
  • Keith R. Berend
    • 3
  • Fred D. Cushner
    • 4
  • David F. Dalury
    • 5
  • Jess H. Lonner
    • 6
  1. 1.Department of Orthopaedic SurgeryLahey Clinic Medical CenterBurlingtonUSA
  2. 2.Rush University Medical CenterChicagoUSA
  3. 3.Joint Implant Surgeons, IncNew AlbanyUSA
  4. 4.Insall Scott Kelly InstituteNew YorkUSA
  5. 5.Towson Orthopaedic AssociatesTowsonUSA
  6. 6.Rothman InstituteThomas Jefferson UniversityPhiladelphiaUSA

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