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My Chronic Knee Pain After Replacement caused by Wrong Size Implant
Hello, I have seen a lot of people with similar stories of chronic pain in their knee after surgery. My experience: I had a total knee replacement although I worked very diligently with Physical Therapists and followed their instructions of what exercises to do at home, I still had extreme pain every single day.Upon the advice of my Ortho, I had a manipulation procedure. Skipping on past months, nothing I could do would relieve the pain short of sitting doing absolutely nothing but elevation and ice therapy. My pain management Dr. performed a Genicular Nerve Block. Nope, that didn't help either. Skipping on past months more, injections and water retention aspirations didn't help either. Then my Ortho decided the only thing to do was to go back in for a little clean up (knee scope). That proved to be not of any use. It's now two years after my replacement. Things are going downhill at a faster pace. I finally convinced another Dr. to take a look at me because you know the other Orthos don't like to take on someone else's patient. Anyhow, he immediately started ruling out causes. Tested for metal allergies, blood tests for infections, Nuclear Bone Scans for hard to detect hiding infections. You name it, he did it. I had mentioned to the original Dr. and now to this new Dr. that I had had such a hard recovery from the surgery that something right from the start must not have been right. My original Dr. thought it was laughable when I asked him a few times if perhaps the wrong sized implant was used . My new Dr. took that question much more seriously. The findings from all the tests showed loosing of the parts of the initial implant. My new Dr. also confirmed with imaging that the femoral part of my implant WAS too large for me causing the slow painful loosening of the whole knee implant. I was very wary but hey what could I do ? I couldn't live like that any more. Yes, I agreed to the revision and oh my gosh ! from the very first day I could tell a big difference in the way I felt. My pain and swelling was hugely less, my progress with Physical Therapy was 100 % more successful. My recovery time was amazing much easier. If there seems to be no explanation from your Ortho about very chronic pain my suggestion would be to find an Ortho to take your question of if you have the correct sized parts for your body implanted into you. You know how it is, when you go to your follow up appointments, you're always told that there's no problem everything looks like it's lined up just fine. I found out the hard way that this is a more common problem than you think. I couldn't believe it myself ! And yes, as some of you have stated my original Ortho Doc was as mad as a hornet that I had gotten another opinion. THAT'S YOUR RIGHT AND THEIR EGO PROBLEM. Hope my story might help someone else out their with unexplained seriously painful chronic pain on a daily basis.
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I ended up getting an MUA (Manipulation under anesthesia) after 11 weeks post-op based on a second opinion. I feel like this has helped immensely but I still have to warm up the knee every day, and it still feels warm after a day of moving, always feels tight (going on 13 weeks since MUA).
I'm glad I did it as its added so much more mobility to my joint. I'm going on 6 months since my surgery. I hope that someday I can forget about it all. It can hike and bicycle... just that damn tight feeling all the time.
Every day I have to stretch, exercise, and get it moving, oiling the exterior up as well so it feels better.
I too agree that there is no consensus on the physical therapy/surgeon coordination of rehabilitation. Does it really benefit a patient to be hurt and pressed down by 2 PT's just to get a number that doesn't last? I am still concerned about developing further scar tissue, so I keep working always. Should I be resting? Ibuprofen still, 200mg every 6 hours, sometimes Tylenol still. Geez... never used to take hardly anything. I still use my ice machine at night sometimes.
Meanwhile, my other knee hurts badly... don't know if I can go forward. Not much follow-up from surgery team.
I love bannisters, I love railings in bathrooms and tall toilets. Different perspective for sure these days!
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1 ReactionHi Babette! Thank you for your posts about your experience.My husband is having tremendous pain from his implant, can you please tell me the name of the orthopedic surgeon who did your revision in Boston. Wishing you the best! Jacqui
First : I’m relieved and happy for you that you found relief, and another good doctor took you on.
I am too am going through this horrid experience. Horrid pain, inability to walk, horrid anxiety and panic attacks. I tried reaching my Dr., when at three weeks post, (having gone through replacement, same knee in 2008.
I was not healing as I knew I should be. Extreme pain, Unable to pick feet up off ground to I had an infection treated in April 2025. New replacement end of July 2025. Finally only two weeks ago, this office ordered x-rays.
The part put into shin- had been put in crooked/slanted. It is pressing into shin, and PA told me there is a risk of bone fracture. I am in much pain, fearful and so stressed, I haven’t been able to do anything- only shuffling a few feet at a time- with out sitting. I feel another doctor (s) should look at me. I am so afraid, and I have lost faith.
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1 Reactionhow did the doctor know to do what implant? replacement?
@cathymw
I am so sorry about your situation. I would urge you to consider doing the other knee BUT with a different surgeon (assuming your health insurance situation permits).
I would think that all surgeons have a variety of sizes available in the operating theater, I know my surgeon did and from his post surgery report, he did fit me and test the size on me while doing the surgery.
You need a surgeon you can trust and you have lost trust in this one. Find one who does it minimally invasively with no routine use of a tourniquet and a modern alignment (kinematic, inverse kinematic or Functional) and, MOST IMPORTANTLY, A SURGEON WHO HAS SUCCESSFULLY DONE YOUR SURGERY AT LEAST A HUNDRED TIMES. When you find someone who does all of that, make sure that she has great hands and a great mind and your chances of a successful surgery are significantly improved.
Unfortunately, there is no absolute certainty of outcome with a total knee replacement. But doing what I have outlined should increase your chances. I did. I am 80 years old and I had no post surgical pain and I even got a bicruciate retaining implant (very rare...I got to keep my PCL and ACL). On day 21 post surgery my PT measured my ROM as 122. I give 90% of the credit to my surgeon.
@steveinarizona I will be taking all your information with me when I meet a new surgeon for sure. I love how you researched and received good results and took your advocacy as an outreach to help others. Thank you.
@cathymw
You're welcome. Our broken healthcare system allows some of us to pick and choose while others are limited to doctors in a particular insurer's network. Other countries, with universal healthcare, also limit one's choices but at least the limitation is universal.
Would you please tell me how much pain there was after waking up from your MUA? I might be having one after about 21 weeks post TKR, because plateauing at 90 degrees for several months. If post MUA pain is as brutal as my post TKR pain was, I'll need to know ahead of time, to arrange a family member to live with me for a while.
@taillie
I am confused. You had a knee implant in 2008. It wasn't healing right so you had a surgeon (same surgeon?) replace it with a new implant in July of this year and based on the x-rays the July 2025 surgery put in the implant in a crooked manner imperiling the implant. Do I have it right?
Was it the same surgeon? A surgeon who repairs a previous knee implant is called a "revision surgeon". Revisions tend to be more difficult so not all hip/knee surgeons do them and of those who do, I would only trust a few to work on my knees.
Go ahead and find a revision surgeon and have her take a look at it. Where are you located? Are you at all convenient to a Mayo Clinic. That would be a good place to get it looked at.
@cathymw Was the pain level following your MUA as high as the post TKR pain level? (I'll need to arrange at home help for after my possible upcoming MUA, as I needed for the ten days after TKR if pain level is high.)