The ideal patient is over sixty years of age. Most are between 60 and 80 years of age. Younger patients tend to be more active leading to premature loosening and wear of the replacement. Young age is a contraindication to total knee replacement.
Extreme osteoporosis (softening of the bone) is also a relative contraindication to total knee replacement. In patients with a significant history of past infection in their knee, total knee replacement may be contraindicated because of the risk of reactivating the infection. A patient with recurrent urinary tract infection secondary to chronic kidney stones, urethral stricture, or other genitourinary problems should have urologic evaluation prior to total knee replacement. Dental abscesses are also a contraindication to Knee Replacement.
Special precautions against infection are taken before, during and after surgery. Antibiotics are used perioperatively. A special surgical room and techniques for a sterile environment are used during surgery. Although the risk is very low, the occurrence of infection can be catastrophic and may require the removal of the prosthesis. To minimize the risk, prophylactic antibiotics are given any time dental manipulation, urinary tract surgery or instrumentation or significant bowel procedures are performed. Any skin infection should also be treated with antibiotics as well, since late prosthetic implant infection may be related to skin infection.