Find out what likely will happen with your knee if you don’t have revision surgery for a failed total replacement.

You’ve had a total knee replacement and, over time, things have gotten worse, leading to a diagnosis of a failed implant.

You’re told you’ll need “revision” surgery: a replacement of some or even all of the hardware.

Suppose you’re afraid to undergo revision surgery for a loosened knee replacement and are wondering if the situation will simply stabilize over time and be managed with painkillers, cold packs, gentle exercise, acupuncture, etc.

There’s bad news if you’ve been hoping that your failed total knee replacement will magically stop getting worse.

For this article I asked a hip and knee replacement surgeon if a failed TKR will necessarily continue getting worse and worse, rather than stop declining and taper off to a standstill status.

“‘Yes; as time goes on, the loosened implants lead to more bone destruction around the joint, and lead to an increased risk of fracture around the joint replacement,” says Jeffrey A. Geller, MD, Associate Chief, Division of Hip & Knee Reconstruction; Director, Minimally Invasive Hip & Knee Replacements, Columbia University Medical Center, New York, NY.

“Pain worsens, but the bone around the replacement weakens, making likelihood of fracture higher as time goes on,” continues Dr. Geller. “Typically the pain worsens and walking becomes more difficult.”

If you’ve been diagnosed with loosened knee replacements, it’s not an issue of whether or not you should undergo the revision surgery; it’s an issue of when, unless you have concurrent medical conditions that contraindicate the revision surgery.

You have to decide if you can continue living in pain, or take that chance with the revision procedure.

My father’s failed TKR generated so much pain that he had no problem deciding on the revision surgery, which so far, has been going well.

How successful is revision surgery?

Dr. Geller explains, “Patients feel much more stable and sturdy just about immediately.

“The recovery is similar to a regular total knee replacement, i.e., three months or so, but the difference is readily apparent.

“If a patient is quite aged, depends on medical comorbidities….better to fix it rather than subject patient to heavy-duty pain meds or risk of falling from pain and weakness in the knee.

“It is generally safer to try to intervene electively for the knee than do an urgent surgery for a fractured wrist or hip.”

Dr. Geller specializes in arthritic disorders of the hip and knee. He has extensive training in joint replacements and performs surgery using some of the latest, most advanced minimally invasive techniques.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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