Despite how common total knee replacement is, many patients end up with failed or loosened hardware that causes pain and crashes their hopes of regaining mobility.
Risk Factors for a Failed TKR
“Oftentimes, we don’t know why they loosen,” says Jeffrey A. Geller, MD, Associate Chief, Division of Hip & Knee Reconstruction; Director, Minimally Invasive Hip & Knee Replacements, Columbia University Medical Center, NY, NY.
“It is assumed that some combination of prolonged time since surgery, and active lifestyle, leads to a process where the cement de-bonds from the bone.
“Rarely, prosthetic design may be inferior, leading to earlier loosening, but most popular designs have done well with good medium to long term results reported in the scientific literature.”
Symptoms of a loosened knee replacement
Pain and swelling in the affected joint
Pain upon sitting and standing
Pain while walking
A sensation of warmth or heat at the knee
A feeling of instability when standing or walking
The symptoms may not occur for a while following the surgery, and thus, the patient may not make the connection, and instead blame the pain on other factors such as nerve compression in the back, which can actually cause pain in the knees.
Since the replacement surgery may initially be successful, it can take quite some time before the patient makes the connection and realizes the possibility that perhaps the knee replacement has become loose.
The pain can radiate beyond the knee and up the thigh, mimicking iliotibial band syndrome, as well as the pain in the upper legs that can result from spinal stenosis (narrowing of the spinal canal).