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Ligament instability after TKR?

Posted by mpirruccel @mpirruccel, May 9, 2023

I had a TKR in august 2021 on left knee due to OA. First 3 months pain was what was expected however it has never gone away, particularly on lateral side of knee. Operating surgeon at 6 months said I was a “slow healer “ and referred me to pain specialist. Pain is worse with stairs, walking. Tolerable when swimming. Cycling is now limited, used to ride 30-50 miles a ride. Icing and massaging every day. Do ROM stretches every day but painful. Have had 2 genicular nerve ablations with no results. Also tried MFR, acupuncture. Taking 75 mg Lyrica at night for sleep. Been to 3 different doctors all with different opinions. Last doc said only solution was a revision as problem is ligament instability. Anyone else gone through this?

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oceanspruce | @oceanspruce | Oct 20, 2025
In reply to @steveinarizona "@oceanspruce So you had what is called a cruciate retaining implant. The PCL being the retained..." + (show)
Profile picture for steveinarizona @steveinarizona

@oceanspruce
So you had what is called a cruciate retaining implant. The PCL being the retained is the cruciate. Have you and your doctor considered an MRI to take a look at the tendon and the PCL?

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@steveinarizona I've not had a "cruciate retaining implant". I've had bilateral total knee replacement surgeries that involved removal of my ACLs and that also resulted in an impingement of the popliteal tendon behind one knee. I've subsequently had an MRI of both knees, but the MRI images are unreadable due to the blackening artifact caused by the metal prostheses.

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stp258 | @stp258 | Oct 20, 2025
In reply to @mpirruccel "@stp258 Still have lateral knee pain 4+ years later☹️. Have appointment to see Dr. Joshua Hustedt..." + (show)
Profile picture for mpirruccel @mpirruccel

@stp258
Still have lateral knee pain 4+ years later☹️. Have appointment to see Dr. Joshua Hustedt of Banner Orthpedics in Scottsdale Arizona to see if I am a good candidate for joint denervation which moves the nerve from where it’s causing pain to a muscle. Relatively new procedure. 1” incisions. Will not consider revision as pain source has not been identified. Google joint denervation and see what you think. Procedure is for people who cannot get tkr or the 20% of us with chronic pain.

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Thank you! I will check this out!

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therealboz | @therealboz | Oct 24, 2025
In reply to @katrina123 "oceanspruce, I had severe pain in a similar area after TKR and there was an orthopedist..." + (show)
Profile picture for katrina123 @katrina123

oceanspruce,
I had severe pain in a similar area after TKR and there was an orthopedist who was going to excise my popliteal tendon and he wrote in a patient portal that he had told me that I could be worse off however he had never told me that so I cancelled the surgery. I am glad that I did cancel because I went to another Orthopedic Clinic and they did an ultrasound and saw right away that I had what is called a fabella bone. This is a fairly rare bone that not everyone has and not all doctors are looking out for it. Sometimes after TKR this bone can cause a lot of pain. I could feel a little lump under the skin.
I had surgery to remove this bone and it immediately took the awful pain away.

I thought I should share this with you since your issues sound similar to what I went through. Maybe you could get an ultrasound to see if this is a possibility.
Katrina

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Hello, I also had an ultrasound and they found the fabella bone. I see this post is over two years old, but wondering how you are doing today. Was the surgery complicated? Thanks.

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1 reply
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katrina123 | @katrina123 | Oct 24, 2025
In reply to @therealboz "Hello, I also had an ultrasound and they found the fabella bone. I see this post..." + (show)
Profile picture for therealboz @therealboz

Hello, I also had an ultrasound and they found the fabella bone. I see this post is over two years old, but wondering how you are doing today. Was the surgery complicated? Thanks.

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@therealboz

I don't know how complicated it was for the surgeons but for me it was easy. I was immediately pain free after the surgery. I only wish that a doctor had looked for this sooner. I spent many months with only a few hours of sleep at night. I am so glad that I went to a different clinic and found a doctor who was able to identify a fabella bone on an ultrasound.
The knee orthopedist who I saw did have his partner do the surgery and he assisted. I can't recall the reason. It could have just been that the one doctor had had experience removing this bone before.

Are you scheduled for surgery?

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steveinarizona | @steveinarizona | Oct 24, 2025
In reply to @katrina123 "oceanspruce, I had severe pain in a similar area after TKR and there was an orthopedist..." + (show)
Profile picture for katrina123 @katrina123

oceanspruce,
I had severe pain in a similar area after TKR and there was an orthopedist who was going to excise my popliteal tendon and he wrote in a patient portal that he had told me that I could be worse off however he had never told me that so I cancelled the surgery. I am glad that I did cancel because I went to another Orthopedic Clinic and they did an ultrasound and saw right away that I had what is called a fabella bone. This is a fairly rare bone that not everyone has and not all doctors are looking out for it. Sometimes after TKR this bone can cause a lot of pain. I could feel a little lump under the skin.
I had surgery to remove this bone and it immediately took the awful pain away.

I thought I should share this with you since your issues sound similar to what I went through. Maybe you could get an ultrasound to see if this is a possibility.
Katrina

Jump to this post

@katrina123

Finding the right doctor is #1 for me. Good work.

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1 reply
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katrina123 | @katrina123 | Oct 25, 2025
In reply to @steveinarizona "@katrina123 Finding the right doctor is #1 for me. Good work." + (show)
Profile picture for steveinarizona @steveinarizona

@katrina123

Finding the right doctor is #1 for me. Good work.

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@steveinarizona

The orthopedist who did my fabella bone surgery is Dr. Jerome DaSilva. He practices at Rebound Orthopedics in Vancouver Washington. If I have another knee replacement for my other knee, I will want him to do it just in case I have another fabella bone.

REPLY
Profile picture for steveinarizona
steveinarizona | @steveinarizona | Oct 25, 2025
In reply to @mpirruccel "@stp258 Still have lateral knee pain 4+ years later☹️. Have appointment to see Dr. Joshua Hustedt..." + (show)
Profile picture for mpirruccel @mpirruccel

@stp258
Still have lateral knee pain 4+ years later☹️. Have appointment to see Dr. Joshua Hustedt of Banner Orthpedics in Scottsdale Arizona to see if I am a good candidate for joint denervation which moves the nerve from where it’s causing pain to a muscle. Relatively new procedure. 1” incisions. Will not consider revision as pain source has not been identified. Google joint denervation and see what you think. Procedure is for people who cannot get tkr or the 20% of us with chronic pain.

Jump to this post

@mpirruccel

I had not heard of this before. It looks very promising and you appear to have found the best possible physician for this. I get a lot of cramping in my hands and may explore this after consulting with my neurologist.

Please update us on this.

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