Spacer replacement 4 years after TKR

Posted by doodles418 @doodles418, Feb 8, 2023

Has anyone been told their plastic spacer is too thin and should be replaced? My knee has been having all kinds of pain, pinching and burning sensations for months now. Xray shows implants are stable, but the spacer may be too thin and gives me the unstable feeling. Surgeon suggests going in and replacing, but not a fan of surgery. Anyone have it done? Successful? Wished they didn't? Thanks for any comments.

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Profile picture for irenesara @irenesara

Just curious what symptoms was your husband having after 18 years of no problems. Also, how his doc diagnosed the problem...just NSAIDS to start out, x-ray and MRI right away?

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@irenesara

My husband was having instability and clicking. Dr took x ray. It clearly showed that the spacers were worn out.

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Oh boy! You sound exactly like me! I’m so glad I found someone who has the same TKR issues. Had TKR in 2020 and stairs have been painful ever since. I got a 2nd opinion and he said I was cemented and that he would put in a spacer. He also said the recovery and pain would be worse than the TKR. Seriously?! I think I’ll take the elevator for now on. Lol. If you do get the spacer, please let me know how it was. I hope you get relief soon.

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Profile picture for bert5258 @bert5258

@irenesara

My husband was having instability and clicking. Dr took x ray. It clearly showed that the spacers were worn out.

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@bert5258 please let us know how it goes since I may have to get a spacer too. Thx!

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Profile picture for jerseygirl21 @jerseygirl21

Oh boy! You sound exactly like me! I’m so glad I found someone who has the same TKR issues. Had TKR in 2020 and stairs have been painful ever since. I got a 2nd opinion and he said I was cemented and that he would put in a spacer. He also said the recovery and pain would be worse than the TKR. Seriously?! I think I’ll take the elevator for now on. Lol. If you do get the spacer, please let me know how it was. I hope you get relief soon.

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@jerseygirl21
I had my spacer replaced 8 weeks ago and the pain was so much less than I thought- really doing fine now, I wouldn’t hesitate to have it done if needed

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My symptoms are exactly like yours but my TKR is only 11 months out and like you, xrays so implant "parts" are correct and stable. I will likely try having the spacer resized but am hesitant because I have had 4 "second opinions" in two separate cities and 2 indicate they would change the spacer size and 2 want to replace the whole artificial knee with completely different "hardware" so I am very confused and frustrated! Wearing a large, complex brace is helpful in allieviating some of the pain so that I can do more; however, when I removed the brace, pain and swelling immediately returns!

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Profile picture for hopelives @hopelives

Thank you all for sharing your stories. I'm also considering a spacer replacement surgery. I can sit and rattle my knee side to side very easily with little effort and with a great deal of sideways movement, clicking, and knocking sounds. I had total knee replacement (TKR with mobile bearing unit) on my left knee at age 46 in 2018, which included a lateral release during the procedure, a shaving of tissue on the lateral side of the knee in order to put the patella back in place. Prior to TKR this knee had several arthroscopic procedures as well as one ACL reconstruction over many years. There has been a great deal of lateral movement (float, play) in the joint ever since the TKR, along with associated pain and swelling. Range of motion is full for a TKR with extension reaching to 0 degrees, yet pain at flexion endpoint, which is probably common with TKR. I am naturally very flexible. All X-rays and nuclear bone scans look beautiful. If anyone has had similar issues, I would greatly appreciate your feedback, especially concerning the consideration for spacer replacement. Thank you.

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You do the plastic spacer surgery? I had my total knee replacement in November 24 and noticed the instability just about 3 to 4 months after the surgery. The surgery did not go well and the surgeon wasn’t listening to me at all. I’m now working with a second surgeon who tells me adding or exchanging the plastic piece and making it 5 mm bigger should help my instability which is side to side, but also global because it buckles and I don’t trust it. You did the surgery how did it go for you@hopelives

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Profile picture for b13moore @b13moore

My symptoms are exactly like yours but my TKR is only 11 months out and like you, xrays so implant "parts" are correct and stable. I will likely try having the spacer resized but am hesitant because I have had 4 "second opinions" in two separate cities and 2 indicate they would change the spacer size and 2 want to replace the whole artificial knee with completely different "hardware" so I am very confused and frustrated! Wearing a large, complex brace is helpful in allieviating some of the pain so that I can do more; however, when I removed the brace, pain and swelling immediately returns!

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@b13moore i’m not sure what I want to do either but I definitely feel your pain! My surgery is not quite two years old and I don’t know whether to undergo another surgery. I read some about replacing the plastic piece and it’s flip a coin on the results as I understand it — tough decision to make i’m not quite sure how to make it!

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Profile picture for kland @kland

Hi, I have the same issue a popping sound when I walk (actually any movement with my knee) but I also have great flexibility with my TKR. My surgeon has suggested to have surgery to replace the spacer with a thicker spacer to tighten up my knee joint. He thinks my knee joint is to loose. Have you done any additional surgery? Or have any other thoughts or recommendations? I am about 8 moths out from surgery.

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@kland did you eventually do the spacer replacement and how did it turn out for you? I’m considering it and do not know what to do but I have total instability any help you can provide is appreciated!

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Profile picture for griswald51 @griswald51

I am having a hard time finding information regarding spacer replacement surgery and recovery expectations. All the literature seems to be on either TKR or replacements due to infection. My 10 year old KR dislocated due to accident. It tore my posterior ligament so is unstable. I am scheduled in 2 months for new spacers but want to know what recovery and PT was like.

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@griswald51 h

Hi, my husband just had his right knee spacer replaced. He had tkr 18 years ago on both knees and has had absolutely no problems until recently. His right knee spacer was 10mm and was worn down to 8 mm. They replaced it with a 14 mm. He is two weeks post op. The staples were removed and he started outpatient PT. He will probably do 4 weeks of PT 2-3 times per week and see his surgeon in one month. They will evaluate and then schedule the left knee.
The incision was made along the original incision for the replacement. My husband (78 years old) was in the hospital overnight. They started PT in the hospital, and he got up and walked with a walker. We had an extra railing installed on our back steps, a grab bar installed in our shower and grab bars on either side of our bedroom toilet (you do not need to raise the seat).

My husband has had excellent range of motion with the original replacements, so he should get good range of motion back. I was not married to him when he had his original surgeries, but he has never had any problems with the replacements until they became loose due to the spacers being worn down.

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