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Review
. 2025 Sep;40(9S1):S72-S83.
doi: 10.1016/j.arth.2025.05.018. Epub 2025 May 12.

How to Manage Intraoperative Complications During Primary Total Knee Arthroplasty

Christopher M Melnic  1 , Jenna A Bernstein  2 , Jeremy M Gililland  3 , Nicholas Sauder  1 , Michael Blankstein  4
Affiliations
Review

How to Manage Intraoperative Complications During Primary Total Knee Arthroplasty

Christopher M Melnic et al. J Arthroplasty. 2025 Sep.

Abstract

Background: Intraoperative complications are ideally prevented altogether, but are nevertheless an inherent and unavoidable risk in primary total knee arthroplasty (TKA).

Methods: This article provides a review of a symposium on primary TKA intraoperative complications that was presented at the American Association of Hip and Knee Surgeons 2024 Annual Meeting.

Results: The following four intraoperative complications were reviewed: 1) medial collateral ligament injury; 2) neurovascular injury; 3) extensor mechanism injury; and 4) periprosthetic fracture.

Conclusions: As the nationwide and per-surgeon volume of primary TKA continues to increase, it is imperative for arthroplasty surgeons to be prepared to prevent, identify, and manage intraoperative complications during primary TKA.

Keywords: MCL injury; extensor mechanism injury; intraoperative complications; neurovascular injury; periprosthetic fracture; total knee arthroplasty.

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