Posterior Dislocation of Total Knee Replacement
Posted in the Knee Replacement Forum
#1 Aug 30, 2010
My surgery for my TKR went extremely well, very little pain post operatively. Rehab was relatively pain free and I was able to flex from 0 to 120 degrees at the end of 4 weeks. Al went well until 3 months later. I was sitting at the table and pushed back to slide the chair out and dislocated the TKR. I had another surgery to correct the problem. 6 months later I'm still having considerable pain and instability from side to side. It looks like I will need more surgery to replace the device.
Has anyone experienced something like this? What was the outcome?
#2 Sep 6, 2010
I was wondering if I could ask you a couple of questions. I too am approximately 6 months out and still having pain, and had two operations in that six months, but mine didn't dislocate, it needed a thicker liner.
Can you tell me what you mean by "dislocated the TKR"? Did they explain to you what exactly happened? And why?
Also, what type of surgery did you have?
Non posterior stablized.
The difference is in "Posterior stabilized" they remove the cruciate ligaments and the poly liner has a post that goes up into a square hole in the femural component to stabilize the joint. This is what I had. The benefit is supposed to be better range of motion.
In the "non posterior stabilized" version, they leave the cruciate ligaments and you don't have the post in the liner.
If you go to Stryker's website, you can see pictures. If you don't know, can you call them and ask them?
But mostly I'm curious as to exactly what you mean my "dislocated" using the prosthetic in your explanation.
#3 Sep 9, 2010
The femur rode up over the tibia and wound up in front of the post designed to provide posterior stability. On a scale of 1 to 10, the pain was a 12. I did get my first ride in an ambulance, but it wasn't very much fun at the time.
The revision involved repair of the ligament on the lateral side and changing the post to a longer one. I was in Florida when this happened so the surgeon who did the original replacement was not the one who repaired it. The surgeon in Florida decided not to change the prosthesis because I was very happy with the original surgery, that is until I had my little problem.
It sounds like I had a posterior stabilized replacement.
Although I'm still having pain and loss of mobility, the real problem is due to the fact that the joint shifts and is unstable. It shifts, not from forwards and backwards, but from side to side.
I have and appointment scheduled with yet another surgeon for Sept 21. I suspect the whole thing needs to be replaced again.
How are you progressing with your recovery? Was the 2nd surgery more painful than the first?
#4 Sep 15, 2010
Thanks. Yes, I understand now what happened to you, and it blows my mind. Yes, you have a posterior stabilized replacement, and that's what I was wondering. I was wondering if it dislocated such that the post came out of its hole in the femural component, which is what it sounds like. Mindboggling, and I really feel your pain, and I understand what you mean by a 12. Some idiot asked me once, and I said 100.
My second operation was identical to the first, with the exception that they didn't have to cut bone the second time. So no, that first week wasn't as painful as the first time around. But on the other hand, the second operation was much harder on me. When I woke up from the anesthesia, I was practically in shock, shaking, it was crazy. That didn't happen the first time. Then when I got home on the third day one morning I went into the bathroom, took off my t-shirt and almost fell down. For about three days I was on the phone with either the doctor, a nurse, or anybody I could get ahold of, asking what the hell was going on. It wasn't as if I almost fainted, it was more like a balance disorder. Very strange, but I got over it.
Meanwhile my knee still gets painful if I do too much like walk around a park on uneven ground (PT told me to do that). If I do leg exercises with weights, I back at week two post-op pain. The doctor told me to stop doing weights and try to "get this behind me". I don't need pain medicine anymore, so that's an improvement. But the jury is still out. I never expected this much trouble and just the fact that something went wrong the first time bothers me.
To be continued.
Let us know how you're doing.
#5 Sep 15, 2010
One other thing. I have alot of crunching, crackling, and clicking going on (crepitis?). The doctor told me in can take a year or more for that to go away (a likely story).
The only thing I can really hold on to for hope is the fact that it IS in fact better now than it was before the second operation. Before the second operation, I was tormented by a "clunk-clunk" on every step I took at home in the quiet. I even recorded it once. I was sure something was going to break. It was too loose. The thicker poly-liner (went from 13mm to 16mm) made a huge difference, and I consider that a success. So far.
#6 Sep 28, 2011
After 2 failed Oxford partial replacements (they came out) I went in for emergency TKR 5 months ago. The looseness and clunking are still extreme, and my doc kept telling me to weather it, I was being impatient because I'm so active, just blew me off, basically. My PT refused to work with me till I got a release since he thought it felt sounded too loose and screwed up. I just got a second opinion and the revision specialist said I'm right, I'm in extreme danger of failure and dislocation. Course I no longer have insurance, so feeling really screwed.
Lower Hutt, New Zealand
#9 Jan 7, 2013
Hi, I am very interested to read this thread. I too dislocated my TKJR while pushing myself up from the dining table. This was treated conservatively with relocation under a light sedation and three weeks in a straight leg brace. I was reassured by my specialist and went off on a long holiday overseas. Imagine my distress when it happened again, similar circumstances, only this time I was in a restaurant! Again, I was sent on my way with reassurance! The third time was getting out of bed and the final straw for me. Back to the Doc, he has replaced the spacer with a thicker one and I am no 6 weeks post op. I don't feel very confident and hope that this is psychological and all will be fine! Time will tell and I certainly have my fingers crossed!
#10 Jan 9, 2013
You are the only other person that I have personally heard of having this problem. I know what you are going through. When the first dislocation was the worst pain I have ever felt. I was out of town at a dinner when it happened. The physician who completed the 2nd surgery was also at the dinner and saw me about 60 sec. after it happend. How cool is that. That surgery replaced the post with a longer one. This did not work, the knee moved out of allignment within 3 months. My problem was solved by replacing the device with a rotating hinged joint, about 370 days after the first surgery. I'm now 2 years post op with no problems. Good luck with your knee. Let me know what happens.
#11 Jan 17, 2013
This is my second knee replacement on the same knee. I rejected the firt after 4 years. Recently I was trying to untie my shoe lace and dislocated my knee. The worst pain I have ever experienced. A first ride in the ambulance to the OR and under light sedation it was put back in place I will see the doctor that did the surgery soon to see what needs to be done
#12 Jan 18, 2013
I am out 6 week my PT says I'm about three weeks ahead of most TKR. My question is no one gives the type of knee used, Mine is a Full Striker and I am very happy with it. the most trouble I have is the discomfort and pain at night in bed I usually stay in bed until my wife goes to sleep then I get up to my recliner then I am able to get some rest. I also have a little click in my knee one Dr says its a ligament rolling over the hardware the other DR. says it is scare tissue.
So would any one help me with the type of knees that have dislocated this is something I want to be careful not to have happen.
#13 Mar 25, 2013
Last night at 12:30, while I was asleep, I experienced my third TKR "dislocation", it "jumped the peg" again, six weeks after the first one. Yes, they all hurt, but I have experienced worse.
The first one happened while I was working out at the Gym a month after TKR on January 8th. My recovery from the TKR operation had gone exceedingly well (up to 125 degrees) so I was doing some of the prescribed muscle strengthening exercises.
The second was two weeks later; I was taking my socks off after returning from dinner out. Following this second dislocation I had a second operation, which lengthened the "peg". The infection following this replacement operation required a third procedure and hospitalization, "washing out" the wound.
I thought I was over the hump after three hospital stays and operations in three months, until last night.
Now I don't know what to do. I have a stiff brace on my leg and am scheduled for an X-Ray tomorrow. I'm sure my OS will recommend a second opinion; perhaps someone who specializes in failed TKRs. I live in the DC area. Any suggestions?
#14 Mar 27, 2013
Dr Mears with the Greater Pittsburg Orthopedics Assoc did my 3rd Surgery, he replaced the replacement. I'm more than 2 years post-op and doing great. It may be a bit far for a second opinion though. I alwys felt lucky that my problem was mechanical and not an infection.
#15 May 9, 2013
I have 2 Stryker Triathalon posterior stabilized knees. The first,(right), was great; no problems at all just clicks when I walk. My other knee was doing as well up until about the 5th or 6th week when, while sitting at my desk it started to draw up. It was very painful and felt like something happened as I straightened it. When I flexed it to around 90° the tibia was displaced posteriorly and, though not excruciatingly painful, it was clear that something was quite wrong. The real pain started when I tried to straighten it back out and stood on it. With a loud snap and a lot of pain it went back into place and was then tolerable. Since then it has displaced probably 30 times each time I successfully reduced it by weight bearing. If I am willing to tolerate the pain of reducing the subluxation I can now dislocate and reduce it at will. My surgeon wants to do a revision, specifically replace the poly insert with one that has a longer post. He said that the insert is the thickest available so increasing the thickness is not an option. I am considering getting prolotherapy injections to the two remaining ligaments to tighten the joint up. After reading so many reports of poor outcomes of revisions I am hesitant to go back in and try to fix it surgically. Has anyone heard of using prolotherapy to tighten up the joint after a TKA?
#16 Jun 16, 2013
I had the dislocation happen several times in a 2 1/2 week period. The final time I ended up with a broken distal femur. I did not recognize that it was dislocating, but also with mine weight bearing and pain would get it back into place.
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