The Painful Or Failing Knee Replacement
The Painful Or Failing Knee Replacement
Total knee replacement is a widely performed and generally successful procedure for relieving chronic knee pain and restoring mobility. However, in some cases, a knee replacement may become painful or lose function months or years after surgery. This could be due to a mechanical issue with the implant, an underlying biological problem, or a separate condition affecting the joint.
If you are experiencing pain, swelling, stiffness, or instability after knee replacement, it is important to seek a thorough assessment to determine the underlying cause and the most appropriate treatment options.
Dr Darren Paterson offers comprehensive evaluation and tailored management for patients with painful or failing knee replacements, including revision surgery where required.
Causes of knee pain after joint replacement
Not all post-operative knee pain is caused by implant failure. Some discomfort may relate to soft tissue irritation, joint inflammation, or biomechanical factors. In other cases, the prosthetic components may become loose or worn, which may require surgical intervention.
Common causes include:
- Component loosening (aseptic loosening)
- Wear of the polyethylene bearing surface
- Infection around the joint
- Instability or joint laxity
- Stiffness due to scar tissue or misalignment
- Patellofemoral tracking issues (kneecap alignment problems)
- Periprosthetic fracture (fracture near the implant)
- Soft tissue inflammation or referred pain
Early assessment helps distinguish between mechanical and non-mechanical causes and ensures timely, targeted treatment.
Signs your knee replacement may be failing
You should seek review if you experience any of the following after your initial recovery period:
- Ongoing or worsening pain in the knee
- Swelling, warmth, or redness around the joint
- Reduced range of motion or persistent stiffness
- Instability or a feeling of the knee giving way
- Cracking, grinding, or unusual noises during movement
- Difficulty walking, kneeling, or climbing stairs
These symptoms may indicate problems with the implant, surrounding bone, or soft tissues. Dr Paterson will assess your symptoms in the context of your overall health, activity level, and original surgical history.
How a painful or failing knee replacement is diagnosed
Dr Paterson will begin by taking a detailed history, examining your knee, and reviewing your original operation records if available. Imaging and testing will help confirm the cause of your symptoms.
Investigations may include:
- X-rays to assess implant position and signs of loosening
- Blood tests to detect infection or inflammation
- Joint aspiration to rule out periprosthetic joint infection
- CT scans for detailed implant alignment or bone integrity
- Bone scans or MRI (where appropriate) to assess surrounding tissues
An accurate diagnosis will help determine whether your symptoms can be managed without surgery or if revision knee replacement is needed.
Treatment options for ongoing pain or suspected failure after knee replacement
In some cases, symptoms can be managed without additional surgery including:
- Physiotherapy to improve muscle strength and joint stability
- Activity modification to reduce stress on the knee
- Pain relief or anti-inflammatory medications
- Injections for inflammation or bursitis
- Use of a walking aid or brace to support the joint
These measures may provide relief for patients whose implants are well-positioned and functioning but who experience soft tissue discomfort or mild instability.
If the implant is loose, worn, infected, or misaligned, revision surgery may be recommended.
Revision knee replacement involves removing the old prosthetic components and replacing them with new implants designed to restore function and address structural problems. This is a more complex procedure than initial knee replacement and requires careful planning. Dr Paterson uses advanced surgical techniques, including patient-specific instrumentation and modern revision systems, to improve accuracy and outcomes.
Recovery after revision surgery may take longer than after a primary knee replacement. Most patients begin physiotherapy shortly after surgery and use crutches or a walker for the first few weeks. Dr Paterson and his team will provide a clear rehabilitation plan and follow-up schedule to support your recovery.
When to seek help for pain or possible failure after knee replacement
If you are experiencing ongoing knee pain, swelling, or difficulty walking after knee replacement surgery, it is important not to ignore these symptoms. A timely review can identify treatable issues and help prevent further joint deterioration.
Dr Darren Paterson offers detailed assessment and personalised treatment planning for painful or failing knee replacements, helping you regain confidence and function in your everyday activities.
