What problems can occur with a total knee replacement?
Sometimes a total knee replacement can become problematic earlier than expected and may require revision surgery. Alternatively, you may be one of the many patients out there who has had a well-performed total knee replacement which has now failed or become problematic with the passage of time.
A problematic total knee replacement is often just that and the symptoms are often difficult to pin down and can be quite vague. Pain may or may not be present all the time – it may be slightly hot, warm or swollen. Your surgeon will examine you in the office and this often yields vital clues as to what the underlying diagnosis or cause could be.
What causes these problems?
The causes of a troublesome total knee replacement can be broadly divided into those intrinsic to the knee replacement or extrinsic to the knee replacement. Extrinsic hip or spine pathology can masquerade as knee pain. Therefore the treating surgeon needs to have a high index of suspicion before focussing on the knee replacement itself. Further, other systemic conditions such as metabolic bone disease/rheumatoid arthritis can all present with pain in the knee.
Causes intrinsic to the knee replacement: loosening, wear, mal-alignment, instability, stiffness (inability to fully bend or flex the knee), flexion contracture (inability to fully extend the knee), periprosthetic fracture, periprosthetic infection.