By Margaret 
A total knee replacement (TKR) is a common and generally successful surgical procedure designed to relieve pain and restore function in a severely damaged knee. Most people experience years of improved mobility and comfort after the surgery. However, like any medical implant, a total knee replacement doesn’t last forever. Over time, some patients may need a replacement of total knee replacement. Recognizing the signs that your knee replacement might be failing is crucial to maintaining your quality of life and preventing further complications.
Total Knee Replacement Longevity
Total knee replacements typically last 15 to 20 years or more, depending on several factors, such as the patient’s age, activity level, weight, and overall health. Wear and tear on the implant components can eventually lead to loosening, damage, or failure. While many patients enjoy long-lasting benefits, it’s important to stay aware of any changes in your knee function or pain levels after your initial surgery.
Persistent Or Increasing Pain
One of the most common signs that your knee replacement may need to be evaluated is the presence of persistent or increasing pain. While some discomfort after surgery is expected, pain should gradually improve as healing progresses. If you notice worsening pain months or years after your replacement—especially pain that interferes with daily activities or worsens during rest—this may indicate a problem.
Pain can arise from several issues, including implant loosening, infection, or wear of the plastic components. It’s essential to consult your orthopedic surgeon if you experience persistent knee pain so they can identify the cause and recommend appropriate treatment.
Reduced Mobility And Stiffness
A successful knee replacement should improve your range of motion and allow for better mobility than before surgery. However, if you begin to experience increasing stiffness, difficulty bending or straightening your knee, or trouble walking or climbing stairs, these symptoms could signal implant failure or joint problems.
Over time, scar tissue or inflammation can restrict movement, or the mechanical components of the implant may become loose or misaligned. Noticing a decline in your knee’s function should prompt a medical evaluation to determine whether revision surgery is necessary.
Swelling And Inflammation
Some swelling around the knee is normal in the immediate recovery phase after surgery, but swelling that persists or returns long after your initial replacement should be investigated. Chronic swelling can indicate an infection, inflammation, or implant loosening.
Infections around the implant, though relatively rare, are serious and may require revision surgery to remove the infected material. Similarly, inflammation due to wear particles from the implant can cause joint damage and pain. If you experience recurrent or unexplained swelling, consult your healthcare provider promptly.
Instability Or A Feeling Of The Knee Giving Way
A knee that feels unstable or gives way during walking or standing is a significant warning sign. The knee joint relies on stable, secure implant components to function correctly. If these components become loose or if the surrounding ligaments are damaged, the knee may lose its stability.
Instability not only affects your ability to move confidently but also increases the risk of falls and further injury. If your knee seems unstable or wobbling, consult a doctor to check your knee replacement.
Changes In Leg Alignment Or Deformity
Wear and loosening of the implant might modify leg position. You might notice your leg appears crooked or bowed or that your knee joint no longer looks or feels aligned properly. This can affect your gait and cause additional pain in the knee, hip, or lower back.
Such changes are serious and typically require evaluation by an orthopedic specialist. Correcting alignment problems often involves revision surgery to replace or adjust the implant components.
Signs Of Infection Or Inflammation
Though less common, infections after total knee replacement are a critical concern. Symptoms may include redness, warmth around the joint, fever, or drainage from the surgical site. Infections require urgent attention as they can damage bone and soft tissue, jeopardizing the implant’s success.
Even low-grade infections may cause subtle symptoms like mild pain or swelling, so any unusual signs should prompt an immediate medical review. Early diagnosis and treatment can prevent major revisions.
When To Seek Medical Evaluation?
If you notice any of these signs—persistent pain, stiffness, swelling, instability, changes in leg shape, or signs of infection—don’t delay in seeking medical evaluation. Your orthopedic surgeon can examine your implant and surrounding tissues and arrange imaging tests like X-rays or MRIs.
Blood or joint fluid testing may be needed to rule out infection. Based on these findings, your surgeon may recommend physical therapy, medication, or revision knee replacement surgery.
Conclusion
A total knee replacement can provide excellent relief and improved function for many years. However, implants can wear out or develop complications that require revision. Being aware of the key signs—such as persistent pain, reduced mobility, swelling, instability, and alignment changes—can help you take timely action. Consult your doctor immediately if you have any knee symptoms. Early intervention can protect your mobility, reduce discomfort, and ensure the best possible outcome for your knee health.