We assessed the prevalence and relevance of putative risk factors for significant postphlebitic syndrome (PPS) in a cohort of 405 patients who underwent single limb cemented total knee arthroplasty. All patients were studied by means of a questionnaire and clinical examination to detect the presence of lower limb venous insufficiency. We found 52 (13%) new cases of postphlebitic syndrome. Comparison of those patients with and without PPS revealed no significant differences in the median age, sex ratio, preoperative mass, primary joint pathology or relevance of primary or revision surgery. A confirmed history of pre- or post-operative deep vein thrombosis was associated with the development of disease. Most cases seemed to develop within 5 years of surgery.