Knee Hyperextension After TKR

Posted by brendaem @brendaem, May 18, 2023

Has anyone who has had TKR experienced a problem with backwards hyperextension of the joint? I had TKR in October 2019. My recovery has been complicated by a sacroiliac joint issue with radiculopathy that has responded to injections and LOTS of PT. However, my knee continues to hyperextend. My ortho X-rays are normal, and the surgeon says sometimes it takes a year, 18 months, 2 years to fully recover. It’s been 3.5 years now and they’re telling me that maybe I need different hardware in the knee. Maybe?? I don’t want another surgery based on a maybe! Has anyone else had to deal with this?

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I saw an ortho last year for second opinion on knee. I am pretty worried. I had atrophy of my quad after TKR in 2020. I could not climb stairs, said it was due to quad shut down, etc But, over the course of 4 years, the hyper extension started. From what I understand, this typically is rare. Saw a neurologist. First thought femoral neuropathy. Year later 2022, saw another neurologist- EMG, had an abnormal EMG. Fast forward- 2023- neuromuscular did EMG, she said normal.

Saw ortho revisionist- aspirated knee, thinks- I have an infection. Waiting more tests in next 2 weeks.

Now, my other knee needs replacement .

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Profile picture for salliesallie @salliesallie

I had total left knee replacement in Sept, 2023...it was a very difficult and painful recovery
I had total right knee replacement in March, 2024. That went better...I noticed that the first surgery, left knee, continued to be more painful and swollen.
Shortly thereafter my left knee was bowing backwards, called
Hyper flexing. I am still in PT and they had not seen a case like mine.
I returned to the surgeon yesterday and he said in all of his years he had not had a case like mine.
He said 3 options ...remove the device and replace it with a henge type of appliance or put in a "plastic wedge" or a full leg brace.
I am not up for another surgery. I am so disappointed...I also have other health issues.
Has anyone ever experienced hyper flexing and what was done about it? I will appreciate your input as I limp along!

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Hello. I am having an issue with hypertension also after 3 acl surgeries. And a total knee replacement in March. My original injury was May 2020 physical therapy after each surgery. Then a whole year of therapy that I’ve just finished. The physical therapist and my surgeon say they have never seen this issue before. I’m feeling defeated As I haven’t walked correctly in almost 5 years.

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Yes, this happens to me. My TKR on my right knee was 7/2024. I am back to walking on average 7,500 steps/day, and most mornings I walk about 3 miles for exercise. The hyperflexing happens once every 1-2 days...scares me because it comes out of nowhere...it doesn't hurt, and once it happens all is good again. My PT believed it' because the muscles aroung my knee aren't strong enough yet...maybe?

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I am finding all of these questions and comments the same ones I have. I had TNR July 2022. I was born with hyper knee extension and at time of surgery my right knee (which was replaced) was measuring -21 degrees. I was never informed by the doctor that this could be a problem with the TNR surgery. Here I am 3 1/2 years later. New knee doctor and had to have 40 cc of fluid drawn off the knee this week. New knee is already extending back -5 degrees or so. Extreme swelling and constant pain. First option was to rule out infection, waiting now on the fluid test and revisit the doctor in several weeks to see where we go from here. He did mention the hinged knee replacement, but I like a lot of the comments am not sure I can go through total knee replacement again. I had very excessive swelling and pain with the first surgery. Any comments and help are appreciated. I will let you know what I am told at next appointment as well. Very discouraging.

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I had total knee replacement 15 months ago. 11 months of PT and 4 months of weight training to build quads and hamstrings.
My knee still hyperextends. I use a brace that helps somewhat. I’m using a walker and cane. I’m considering revision surgery.
I’m sorry I ever did the original surgery.

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Profile picture for zaydez @zaydez

I had total knee replacement 15 months ago. 11 months of PT and 4 months of weight training to build quads and hamstrings.
My knee still hyperextends. I use a brace that helps somewhat. I’m using a walker and cane. I’m considering revision surgery.
I’m sorry I ever did the original surgery.

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@zaydez
Hello, I have had both knees replaced and revisions on both. 1st revision by another doctor went very well...next revision...Dr. said he found soft bone and had me wear a full leg brace and stay in the hospital TWO WEEKS...I was diagnosed with Cellulitis (look it up) I believe it was due to having the brace on so long. I have been back in the hospital twice since then. I have been on 3 rounds of antibiotics...I saw him 2 weeks ago and he prescribed compression stockings...I have not put them on yet because I see my Primary Dr this week and see what she says. I also wish that I had not had the 2nd revision.
Prayers and good lucy

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Profile picture for salliesallie @salliesallie

@zaydez
Hello, I have had both knees replaced and revisions on both. 1st revision by another doctor went very well...next revision...Dr. said he found soft bone and had me wear a full leg brace and stay in the hospital TWO WEEKS...I was diagnosed with Cellulitis (look it up) I believe it was due to having the brace on so long. I have been back in the hospital twice since then. I have been on 3 rounds of antibiotics...I saw him 2 weeks ago and he prescribed compression stockings...I have not put them on yet because I see my Primary Dr this week and see what she says. I also wish that I had not had the 2nd revision.
Prayers and good lucy

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@salliesallie

If the first revision went well, why did you go to another doctor for the second revision? Can you go back to him for an independent review of your status?

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Hello,
...Sorry that I did not make myself clear. I went to Dr. A for reconstruction of both knees...that failed.
I went to Dr. B for both revisions...the 1st one has had excellent results...the 2nd revision on the other knee has been a failure.

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