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'm sorry you were going through that pain. It is so difficult to pursue a solution in the face of so many different opinions and uncertainties. It is a delicate balance between not giving up and accepting the uncontrollable variables. It has been 29 years since my first surgery on my left knee, and the tkr surgery was surgery 9. No other joint surgeries for me, thank goodness. I certainly have a greater appreciation than I previously did for life in general, but that doesn't mean I'm giving up on my pursuit of what could be a solution. My own mother's life was saved when she sought a fourth opinion on a cancer diagnosis. Accepting is not surrendering. Thanks again for sharing. Stay strong, hope lives.

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@rggj

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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Thank you for sharing. I'd like to tighten my knee's "tie rod" as well. A surgeon did tell me that decades down the road there will undoubtedly be an easier way to address this need to tighten the lateral play in some tkr patients such as us. Bring on the future.

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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 am scheduling for 12/22 as only 1 of the two are worn. they cannot explain why but that I was the second patient with the same knee(Left) same year with the same wear to have come in ON THE SAME DAY lol anyway. I am traveling to NY to get mine done and staying in NY for 10 days after. How were you feeling around that time? I have to drive in a car for 5-6 hours.

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Hi I joined the group because I am also facing a TKR spacer replacement surgery. I am 1 year out from the TKR and have stability issues walking. I can walk fine but the muscles fatigue after time. The knee has felt unsteady or wobbly since I could really walk on it. The doctor said this would be a spacer replacement only - nothing more. It sounds like that surgery is not too bad, but I am really worried about infection. Does anyone know if that is more of a potential problem going back into the joint? What about actual surgery time? Were you on a walker and for how long? What about driving? Anyone wonder why the spacer was too small to start with? How do they select the spacer?

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@rknee

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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Hi there, I am laying in the hospital bed now after having three full take on right knee and one revision today to replace the plastic from 22 mm to 24 mm. Last take was 10/22, constant swelling, pain 24/7….constant draining of fluid 5-6 syringes.
Surgery lasted 48 minutes, not invasive at all, knee not so swollen at all so far.
This larger plastic is supposed to not let the body produce so much fluid as per the Dr. He claims he has done this before many times and so far it has worked w other patients.
I feel good about this decision to have had it done.
Go for ur larger plastic if u have to, good luck.
I’m in N. Ga.

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I had a TKR 1 yr ago and have been having clunk feeling. Was always told I need to strengthen and that it would go away. Only yr followup the Dr is now saying I need to do a revision surgery to add a thicker insert… said it wouldn’t be as difficult.

Very anxious as I had a hard time recovering the original surgery as I have allergies to steroids/anti inflammatory meds.
What I need to know is it necessary to do surgery .. was there any complications.. as we all know redoing surgery can lead to many problems.

Can one strengthen to help the instability?

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@prawleyn

Hi I joined the group because I am also facing a TKR spacer replacement surgery. I am 1 year out from the TKR and have stability issues walking. I can walk fine but the muscles fatigue after time. The knee has felt unsteady or wobbly since I could really walk on it. The doctor said this would be a spacer replacement only - nothing more. It sounds like that surgery is not too bad, but I am really worried about infection. Does anyone know if that is more of a potential problem going back into the joint? What about actual surgery time? Were you on a walker and for how long? What about driving? Anyone wonder why the spacer was too small to start with? How do they select the spacer?

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I too have same issue and concerns. I am not sure why this happened. I am 1 yr now since the TKR and very anxious as to what to do. Is surgery necessary? Can strengthening muscles help instead of doing surgery?

Did you get a second opinion?

Would like to know what your decision was

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The plastic spacer in my knee wore down in 3 years. Had it replaced 5 months ago. Only the plastic spacer was replaced. For me it was as painful initially as original TKR but the recovery period was more brief. My knee feels fairly stable now. Still hurts at times but bearable. It has buckled a few times. Will need to ask about this if it continues. Hope it goes away. I do not want another revision.

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@williekeen

I too have same issue and concerns. I am not sure why this happened. I am 1 yr now since the TKR and very anxious as to what to do. Is surgery necessary? Can strengthening muscles help instead of doing surgery?

Did you get a second opinion?

Would like to know what your decision was

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Hello - I am 15 weeks out now from this procedure. Thankfully no infections. I felt I had to do this surgery as I could not walk very well. There is no way I can know if you could avoid it somehow. I did get a second opinion and he also recommended it.
I am still having pain and swelling but the knee does feel more stable. I am thinking this will resolve this month - that would be 20 weeks. As they do not cut bone or muscle for this operation, I would think it would heal sooner. But there are possible reasons it might take longer - they removed scar tissue, I am older, the muscles need time to adapt to the thicker spacer. Stay tuned for an update if you - or anyone else - is interested.

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Thankyou for replying. Pls keep me updated. I am trying to get a second opinion but not many surgeons want to
Give an opinion of another surgeons work. At least that is what I am running into.

How did you know you needed the revision? Did it show on X-rays? Or just instability when you walk? What were you feeling? I have this clunk movement when I move my leg… it’s so distracting.. I feel it every time..

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