Connect
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.
Like
Helpful
HugInterested in more discussions like this? Go to the Joint Replacements Support Group.
Connect
@cathymw
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.
@tonilynn My pain levels were always very well controlled by my healthcare team from the get go. After surgery I kept a spreadsheet and kept track of when I took my pain meds. I always took 5mg oxycodone an hour before physical therapy. When 2 PT staff would press down on my knee to straighten me or to bend me, that pain was terrible. After about 6 weeks of going no where with that, this is when I sought a second surgical opinion, leading to the MUA.
After theMUA, I had more oxycodone prescribed, which I took for the 4 hour trip home and for a good night’s sleep. I really didn’t need it except I would take it before physical therapy at first. PT would ice me too. I was pretty swollen initially. But I healed pretty quickly and the swelling went down.
Maybe help just to drive you to therapy if you take a pain meds?
I loved my ice machine for pain control and comfort as well.
You will be glad you will get your knee working!!
Best wishes.
-
Like -
Helpful -
Hug
1 ReactionHow was wrong size implant diagnosed? Did the cement give away?
@melcpa86
Thank you for your story. My experience is somewhat like yours with eight years of multi-doctors, revisions, PT, and bogus diagnosis. My last Ortho (only this week) stated I have a loose implant. I couldn't see what he saw when reviewing the bone-scan and needless to say, with all the past bogus diagnosis I'm reluctant to undergo another revision.
@ouch89 is surgery recommended or physical therapy for loosening implant?
@babette - Like you, I had a Depuy Attune implant used for my first total knee replacement in 2018. I too knew something was wrong from the beginning. Original surgeon downplayed my issues, insisted everything looked good. Fast forward- it took me 4 years to find an ortho surgeon to do testing and discover the implant was not only loose due to cement not adhering to it, but it was also the wrong size! Am doing very well after revision by new doctor. Am wondering if you had any luck with any legal action against makers of the implant? I have not.
-
Like -
Helpful -
Hug
2 ReactionsGood for you! You must be your own advocate as exhausting as it may be.
This is one reason I am a proponent of custom made implantable joints!!
I had s bilateral replacement years back using that method and if I ever need a new knee or etc that is the route I will seek from a MD who utilizes that technique!
@elaineva so brand name do you have now?
Just celebrated my 1 year anniversary after a revision of my left total knee arthroplasty (TKA) on February 5. 2025 The original replacement was done in November 2024. Initial procedure was uneventful and I was progressing well post-op. I was having some initial but persistent pain, swelling, redness and warmth at the surgical site. Discussed with the original surgeon and he dismissed it saying it was normal. Continued with physical therapy but the pain, redness, swelling and warmth persisted. The surgeon again dismissed it saying that all of the post op radiology studies and his physical exams indicated that the hardware was intact. He suggested that I be referred to a pain management specialist for a genicular nerve block. I went for the consultation with the pain management specialist and his recommendation was to do the genicular nerve block. It was in the process of being set up but the procedure was considered to be "experimental" and therefore not approved by my insurance company. I went back to the surgeon after the pain management consultation and told him the procedure was considered "experimental" and not covered by insurance. His response was that I could just pay for the procedure out of pocket or just "live with it". Having worked in healthcare (clinical) for almost 50 years, that is not an appropriate response from a healthcare provider, especially from the Chief of Joint Replacement at a major teaching hospital. I left the office and sought a second opinion. Sought out a surgeon that was experienced in TKA revision. Saw the second opinion surgeon. He did a thorough exam, reviewed all diagnostic imaging studies and determined that there was a definite problem. He suspected that the initial implant had not been correctly balanced and that was contributing to the symptoms that I was experiencing. He made the arrangements for the revision surgery and had representatives from the original implant manufacturer to be present to assist if adjustments could be made to the original implant. In the event adjustments could not be made and the implant had to be explanted, he also had representatives from another implant manufacturer available to assist with the total revision. Once exposing the joint, it was determined that the original implant was not correctly balanced and could not be. The decision was made to totally explant the initial hardware and replace it and balance it with a different implant from the other manufacturer. The revision surgery was successful and post op progress was uneventful. The post op office visits showed no sign of pain, redness and warmth that were previously experienced. Totally pain and symptom free now.
As a patient, you must be your own advocate. If a doctor tells you to "Just live with it", definitely seek a second opinion. You have to be persistent. I am so glad I was, but had to endure 14 months of pain and discomfort to finally get the issue resolved.
-
Like -
Helpful -
Hug
7 Reactions