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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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b13moore | @b13moore | Feb 12 12:13pm

I had TKR in July, 2025, and first few weeks I made really great progress with PT but after the first month or two, my progress stopped because the knee kept swelling and had fluid build up. I was checked for infection and also CT scans and xrays that the original surgeon said cleared me of any problems with the implant. Four visits and much frustration and depression with my lack of progress despite twice/week PT visits, my physical therapist suggested I seek a second opinion, which I did and the new surgeon examined my knee for only about 5 minutes before telling me that I would need a larger spacer. I don't do well with strong pain medication and I certainly don't want to spend another whole year of my life (I'm 75) in pain and rehab to recover from another surgery but right now I am extremely limited in my activities and pretty much in constant pain regardless of what I do. Would love to hear from anyone who has had this particular type of revision about your recovery and general improvement/no improvement from having a larger spacer "installed."

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dbduffer | @dbduffer | Feb 12 5:01pm
In reply to @canesfan "I am considering having TKR revision surgery. I had my surgery about 2 years ago. I..." + (show)
Profile picture for canesfan @canesfan

I am considering having TKR revision surgery. I had my surgery about 2 years ago. I felt that I was well ahead of the recovery curve. After about 3 weeks I was able to walk downstairs linking my steps together (which is the hard part). However, while doing so, I felt like the parts slipped, there was extreme pain, and I fell. Fortunately, I fell on my ass and there was no injury. The pain stopped immediately as I fell. Later that day, the same situation occurred again and again I fortunately fell backward. A few days later at my physical therapy, I was doing an exercise where I was raising up and down on the bad knee when it collapsed on me in front of the PT. He informed the surgeon and he scheduled an x-ray but made no recommendation.

Since then, I have managed the problem. From time to time, I feel the parts slipping. There is pain, I usually scream but usually don't fall and then go back to what I was doing. My balance is very poor but I'm OK as long as there is no pain. I also walk with a very bad limp, and it seems to be getting worse. I'm worried that over time, walking will become very difficult.

I have seen a TKR revision specialist. He ordered a bone scan which showed that my TKR parts have not loosened nor is there any infection. He is hopeful that all that he needs to do is install a bigger spacer to correct my issues. Has anyone had a similar situation to mine where the surgery failed right after the surgery? I've read that the recovery if all that is required is to do is replace the spacer, is much quicker than the full surgery. Could I expect to be able to walk without crutches in 3 to 4 weeks? How long would it take to resume an activity like golf? What is the pain level like? I had opioids after TKR. Are opioids needed just to replace the spacer?

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@canesfan
My TKR (12/23) did not have a good result. My symptoms were swelling, inflammation and chronic pain on the lateral side of the knee. Walking is difficult but going downstairs or downhill is very painful.
I had consultations with four orthopedic surgeons and their best diagnosis was instability. They believed that my knee implant was too loose and was causing these symptoms.
I had revision surgery (7/25) to replace the insert with one that is semi constrained. The thickness of my original insert was correct, but the semi constrained insert is designed to provide more stability.
Unfortunately, this did not help and at two years + my knee is a mess.
Regarding your concern about post surgery and rehab for just the insert it is much easier than the original TKR as there is no bone cutting and less trauma to the body. You will be up and about much quicker and need less pain meds.
Good luck and I hope you have a very good result from the procedure.

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ezas123 | @ezas123 | Feb 13 1:35pm
In reply to @odess13 "Can I ask a question is it possiable for my spacer to wear out within 7..." + (show)
Profile picture for odess13 @odess13

Can I ask a question is it possiable for my spacer to wear out within 7 months I think it was my doctor who perform the surgery now I have to get a new spacer put in by another doctor he referred me to because he kept telling me nuttin was wrong I have been in pain since I had my first knee replacement surgery on march 4 2025

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@odess13 I was just reading through sorry to hear so many people in pain . Most of the time there is nothing you can do. Dr put wrong size knee in but was within his scope . Unless you have infection or gross malpractice usually no lawyer will bother with you . But if I were you I would contact a lawyer have him take a look . Some of These Dr feel they are like gods no repercussions , most of the time that is the way it is . Maybe if they had to be held accountable they wouldn’t perform as many knee surgeries. Maybe they would question before they do a surgery.. because I can guarantee is when he surgery is they’re doing and not. Everyone is a candidate that they’re doing it too. Good luck I hope you get it figured out out

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waskowskije | @waskowskije | Apr 19 12:45pm
In reply to @doodles418 "Thank you for your reply. How long was the recovery time? I'm 66 yrs, and active...." + (show)
Profile picture for doodles418 @doodles418

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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@doodles418

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dbduffer | @dbduffer | Apr 20 11:04am
In reply to @ezas123 "@odess13 I was just reading through sorry to hear so many people in pain . Most..." + (show)
Profile picture for ezas123 @ezas123

@odess13 I was just reading through sorry to hear so many people in pain . Most of the time there is nothing you can do. Dr put wrong size knee in but was within his scope . Unless you have infection or gross malpractice usually no lawyer will bother with you . But if I were you I would contact a lawyer have him take a look . Some of These Dr feel they are like gods no repercussions , most of the time that is the way it is . Maybe if they had to be held accountable they wouldn’t perform as many knee surgeries. Maybe they would question before they do a surgery.. because I can guarantee is when he surgery is they’re doing and not. Everyone is a candidate that they’re doing it too. Good luck I hope you get it figured out out

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@ezas123

Thanks for your post.

My TKR (12/23) did not turn out well. I think that the surgeon may have installed it improperly but four other surgeons have examined me and they can see nothing wrong on any images.

I have had 10 Orthopedic surgeries including 4 implants in the last 15 years. Every surgery has risks; there is no guarantee. About 15 - 20 % of TKR patients are not completely satisfied with their result. There are some like mine which are the rare exception.
I will have a full revision next week and hopefully this will resolve or at least mitigate the pain.

I have a legal backgound. Without an obvious issue pointing to malpractice most any case, if an attorney would take it, would fail.
As disappointed and frustrated as I am I prefer to direct this energy to getting my knee fixed.

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ezas123 | @ezas123 | Apr 20 12:34pm
In reply to @dbduffer "@ezas123 Thanks for your post. My TKR (12/23) did not turn out well. I think that..." + (show)
Profile picture for dbduffer @dbduffer

@ezas123

Thanks for your post.

My TKR (12/23) did not turn out well. I think that the surgeon may have installed it improperly but four other surgeons have examined me and they can see nothing wrong on any images.

I have had 10 Orthopedic surgeries including 4 implants in the last 15 years. Every surgery has risks; there is no guarantee. About 15 - 20 % of TKR patients are not completely satisfied with their result. There are some like mine which are the rare exception.
I will have a full revision next week and hopefully this will resolve or at least mitigate the pain.

I have a legal backgound. Without an obvious issue pointing to malpractice most any case, if an attorney would take it, would fail.
As disappointed and frustrated as I am I prefer to direct this energy to getting my knee fixed.

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@dbduffer good luck on your revision. Staying positive is what it is all about.

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