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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I have had several knee surgeries to replace my spacer due to the fact my ligaments and tendons wouldn't keep my knee stable. Surgery to replace spacer is lots easier than having total knee replacement and recovery time is a lot easier and shorter on length of time. If you have any questions please let me know.

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@bionicwoman

I have had several knee surgeries to replace my spacer due to the fact my ligaments and tendons wouldn't keep my knee stable. Surgery to replace spacer is lots easier than having total knee replacement and recovery time is a lot easier and shorter on length of time. If you have any questions please let me know.

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Thank you for your reply. How long was the recovery time? I'm 66 yrs, and active. My knees are better in the morning, but by 7,000 steps I'm feeling the pain, and by 12,000 steps I'm limping along! I want to be able to enjoy my daily walks again. Did you find the replacement successful?

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Recovery was much shorter. I think it was like 4 weeks if you worked the program of P. T. I found the new spacer was worth the surgery.

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@bionicwoman

Recovery was much shorter. I think it was like 4 weeks if you worked the program of P. T. I found the new spacer was worth the surgery.

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I've heard other stories of spacer failure in TKRs. I believe they have since improved the material used, an ultra-hardened form of polyethylene I believe. This is why people with TKRs can't run. These spacers provide no cushioning, they simply separate the femur and tibia - the job the menisci performed before they disappeared! Too bad science can't come up with a replacement for cartilage.......

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@bionicwoman

Recovery was much shorter. I think it was like 4 weeks if you worked the program of P. T. I found the new spacer was worth the surgery.

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Thanks for the encouragement for my wife and I. She had a TKR about 18 months ago. Her knee makes such a loud popping noise that people notice it and ask about the noise. It has caused her to become embarrassed by it. It sounds similar to when you snap your finders but louder. We had a return visit about two months ago with the original surgeon who is puzzled as to the cause of the noise. He talked with a number of his fellow surgeons in the practice and believe it might be a tracking problem. We saw a new surgeon last week and he shook his head, like the surgeon who did the original surgery. He believes it might be an equipment problem, possible failure of the spacer. She will be seeing another surgeon to get his opinion since nobody, including the fine people on this website, have ever heard of a similar case. Strange thing she has great flexibility in the knee and her greatest pain is of a night. She like you is very active, I lovingly refer to as my “Energizer Bunny”. Thanks again for your encouraging story.

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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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I’ve been having pain in my TKR every time I stand up. My original surgeon said he think my hardware is loose but doesn’t know why and I might need a revision. Today the second opinion surgeon (who did a lot more tests and x-rays) has the opinion that it’s not that my hardware is loose, but that my ligaments are too loose and not providing stability to hold the prothesis in place. Which has created a swollen bursa on the inside portion of my knee. Short term diagnostic solution: steroid injection and ordered a knee sleeve brace to see if it relieves my pain by holding the prothesis in place. If this works, he suggests surgery to replace the plastic spacer with a thicker one. A simpler surgery than a revision because no bone-cutting. I have a trip planned in two months so this gives me time to see if it helps. I feel much better with this diagnosis! Time will tell!

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@bionicwoman

I have had several knee surgeries to replace my spacer due to the fact my ligaments and tendons wouldn't keep my knee stable. Surgery to replace spacer is lots easier than having total knee replacement and recovery time is a lot easier and shorter on length of time. If you have any questions please let me know.

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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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@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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I too have severe thumping when swinging the knee back and forth. As you stated, my surgeon said the spacers could be replaced, but at this point (3 years out) I am not if a mind to do the procedure. The pain isn’t so bad that I can’t take it. I just tell people that my Tyrods need replacing. Good luck.

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I have had clicking in my left knee since 3 months post op. I am now 23 months post op. I have been told by 3 different doctors that this normal. One said to live with the pain, another said he would try arthroscopic surgery with 50-75% chance of less pain and third said I need a revision. Doesn’t seem normal to me! Nothing ever mentioned about the spacer being inappropriate. X ray and bone scan look fine but still have persistent lateral exterior pain with walking, swimming and going down stairs. Tried MFR, nothing. Taping seems to be the most effective pain relief but you can’t have tape on all the time. One pain doc wants to implant a peripheral nerve stimulator in my leg but not interested. To see another pain doc next week for some type of manipulation but not sure what can be done at this point in time. Ugh!!

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