Spacer replacement 4 years after TKR

Posted by doodles418 @doodles418, Feb 8, 2023

Has anyone been told their plastic spacer is too thin and should be replaced? My knee has been having all kinds of pain, pinching and burning sensations for months now. Xray shows implants are stable, but the spacer may be too thin and gives me the unstable feeling. Surgeon suggests going in and replacing, but not a fan of surgery. Anyone have it done? Successful? Wished they didn't? Thanks for any comments.

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@bionicwoman

I have had several knee surgeries to replace my spacer due to the fact my ligaments and tendons wouldn't keep my knee stable. Surgery to replace spacer is lots easier than having total knee replacement and recovery time is a lot easier and shorter on length of time. If you have any questions please let me know.

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I am having a hard time finding information regarding spacer replacement surgery and recovery expectations. All the literature seems to be on either TKR or replacements due to infection. My 10 year old KR dislocated due to accident. It tore my posterior ligament so is unstable. I am scheduled in 2 months for new spacers but want to know what recovery and PT was like.

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@aliciavillarosa

I feel like that's what's happening with me with my right knee after a couple years of putting a thicker spacer in. I feel friction on the outside. I'm seeing my surgeon next week but anxious to hear what yours says. And I feel like the stretching to relieve ITB tightness and tendinitis has been helping, but read about possible arthroscopic procedure to shave a little bit. I found this article informative
https://orthopedicreviews.openmedicalpublishing.org/article/93014-isolated-lateral-sided-knee-pain-in-total-knee-arthroplasty-a-review

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Hi,
Thanks for sending the link to the article. I may be contacting the authors to see if they can recommend someone in Northern California who has done arthroscopic work after a TKR. I don't want them just going in with the camera without knowing what the problem is. All the surgeons I have seen, 4 total, either do not know what the problem is and recommend a revision or say that is the way it is. This is my last hope for meaningful pain relief. I did myofascial release therapy for my IT band for a few months and it didn't do anything. There is definitely an impingement going on. keep you posted.

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@prawleyn

There have been developments regarding my knee. A new doctor has found the cause of the problem and it is infection. I don't know for sure but I believe this was from the revision. Either way, I now regret going forward with this revision - even with a second, concurring opinion. My advice, FWIW, now is to STOP and get testing done before any revision! The original doctor never mentioned testing. I found a new, more modern doctor and he found the cause. I reached out to a clinic known for orthopedic excellence and they would not see me because I had this revision. I am glad I have found some care as many doctors shy away from these problems. In the end I look at this as a positive. I have been struggling with this one for almost 2 years. Now that we know what the problem is I am very confident that this knee will improve significantly. I am going to be okay. Good luck all!

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I wanted to give everybody an update. I had my revision surgery on October 1. I am doing so well and I am so glad I did the revision surgery. I have less pain walking now two weeks after surgery than I did before the surgery. When I met with my surgeon before the surgery, we talked about replacing my 10 mm spacer with an 11 or 12. In the end they ended up using a 14 because there was that much play in my joint when they opened it up. I had very little scar tissue and my inflammation had come down so well for my first total knee replacement, which created a lot of space. I just wanted to put some positive positive here because revision surgery is very scary. You have no idea what the outcome is going to be, but I trusted my surgeon that he said all the people he’s done revision for which are very few were very happy with the results. I can say that it was a good experience on my end.

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@griswald51

I am having a hard time finding information regarding spacer replacement surgery and recovery expectations. All the literature seems to be on either TKR or replacements due to infection. My 10 year old KR dislocated due to accident. It tore my posterior ligament so is unstable. I am scheduled in 2 months for new spacers but want to know what recovery and PT was like.

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I had a spacer replaced. I felt the initial pain was as bad for a few days. However the physical therapy was easier and results faster. Generally the recovery was easier and faster.

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@bacbaa

I wanted to give everybody an update. I had my revision surgery on October 1. I am doing so well and I am so glad I did the revision surgery. I have less pain walking now two weeks after surgery than I did before the surgery. When I met with my surgeon before the surgery, we talked about replacing my 10 mm spacer with an 11 or 12. In the end they ended up using a 14 because there was that much play in my joint when they opened it up. I had very little scar tissue and my inflammation had come down so well for my first total knee replacement, which created a lot of space. I just wanted to put some positive positive here because revision surgery is very scary. You have no idea what the outcome is going to be, but I trusted my surgeon that he said all the people he’s done revision for which are very few were very happy with the results. I can say that it was a good experience on my end.

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How far away from your initial surgery were you and are you make it female. I've been having problems from the start now almost 5 months. 2nd opinion doc says I have patellar Clunk syndrome or the wrong size spacer or patellar button. When did you become aware something was not right and what were your symptoms? and what was the opinion of your surgeon at first.?

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@irenesara

How far away from your initial surgery were you and are you make it female. I've been having problems from the start now almost 5 months. 2nd opinion doc says I have patellar Clunk syndrome or the wrong size spacer or patellar button. When did you become aware something was not right and what were your symptoms? and what was the opinion of your surgeon at first.?

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I am a female, any my TKR was a little over a year ago, 7/21/23. I knew around 5-6 months that something wasn’t right. Had a lot of things in my knee. Which surgeon said that was normal. He said let’s see if it’s still there a year. But I was the information continue to come down in my body and I had very little scar tissue. It was very apparent that something was wrong. I’m actually walking in the north now after that revisions so then I was after my TKR at the year mark. Started at the typically unless there’s something major wrong don’t do anything until the year. I hope this helps. Feel free to ask me any other questions.

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I did have that exact surgery 4.5 yrs later.

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I had a revision a little over a year after my TKR for a larger spacer. Knee had hyperextension. I found overall that it was an easier surgery than the original surgery.

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I had a TKR on 03-13-18 and was in pain until I had a revision on 12-26-23. During this almost 6 year period I complained about the feeling of a lose knee with loud clunking. The sound was so loud my wife could hear my knee while I walked across the room. Following the surgery my doctor told me I put a thicker spacer in that should take care of the clunking. The surgery went well with less pain and quicker recovery, but the clunking, although reduced, remains.
In my case answering the question "would I do it over again" is elusive, because giving up one year plus of your life in recovery for a questionable outcome is a difficult decision.

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