Did they give you a reason for not changing the spacer at the time of your femur prosthetic replacement at the time of your first replacement? I've been having deep hard clunkig for 15 months..since day 1 after TKR. Had arthroscopy cuz of what my doc thought was patellar clunk syndrome and actually had quite a bit of scar tissue removed. Unfortunately it did nothing to help the clunking. Now he's saying it's likely mechanical clunking from some instability or the patella not tracking perfectly. I'm so discouraged. You are brave and I hope this next surgery helps and I would love to hear from you after for an update. Thank you so much for responding.