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Can a painful total knee replacement be repaired?

A painful total knee replacement can be repaired if a correctable cause for knee replacement pain is determined. For example, if pain is caused by loosening, then there are high chances of improvement with revision surgery. Revision surgery for unexplained pain is not as successful.

Dr. William A. Leone, MD
Orthopedic Surgeon

A proper workup for a painful total knee replacement (TKR) focuses on three critical conditions that must be combined to recreate a stable, pain-free TKR with a good result. The mechanical axis must be restored, the soft tissues must be balanced throughout the range of motion and normal knee kinematics recreated. However, it is very difficult to accomplish these conditions consistently, particularly with some pathology and deformities.

Orthopedic surgeons address these goals by using two different computer systems, which have vastly improved the consistency and results people achieve after TKR. These computers provide data and measurements that are more accurate and reproducible, as well as improve decision-making during surgery. By using these computer systems, surgeons are much more aware of how subtle changes in implant position, boney resection and the loading pressures experienced by the surrounding ligamentous sleeve vastly affect the knee’s final balance and kinematics. This greatly enhances the final result.

Typically, surgeons attempt to optimally rotate the tibial component to match the femoral component by the “looking and feeling” method of sizing up the anatomic features or landmarks on the bone. Many times, the precise location of these landmarks is difficult to define or feel, especially in a deformed and arthritic knee, and this leads to a less-than-desired accuracy. Patella tracking also is majorly affected by femoral rotation.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.