The number of total knee arthroplasties performed for diseases other than primary osteoarthritis are increasing. These patients are operated for total knee replacement mostly secondary to rheumatoid arthritis, hemophilic arthropathy, failed high tibial osteotomy and neuropathic arthropathy. It should be kept in mind that these patients may have significant medical problems additional to their orthopedic disease and these problems may affect the surgical outcomes. Their medical status closely affects the complication rate after surgery. Some different complications could be observed after the operation for non-primary osteoarthritis. Being aware of disease specific complications helps in reducing complication rate and improving outcomes. In this review, disease specific complications of primary total knee arthroplasties for non-primary osteoarthritis will be discussed.