A total knee replacement is a highly successful surgery with numerous benefits for patients suffering from chronic debilitating knee pain and mobility issues due to painful and deformed knees.

A successful knee replacement provides significant pain relief, improved mobility and function, better quality of life, correction of deformities, reduced need for pain medication, better sleep and mental health, and increased physical activity.

While knee replacement surgery has a very high success rate and is a routine procedure, like any major surgery, it does carry potential risks and complications, and at times patients are not fully satisfied. Though most knee-replacement surgeries last for many years and some for decades, ultimately they may wear out, requiring a repeat surgery.

What are the red-flag signs of a failing total knee replacement for which you should seek an orthopaedic consultation?

The primary warning signs that warrant an immediate consultation include:

Sudden or persistent severe pain: New or worsening pain years after the operation, especially pain not relieved by rest or medication or pain that wakes you at night, may suggest implant loosening or infection.
Signs of infection: Fever, chills, increasing redness, warmth, swelling around the knee joint, drainage, oozing, pus, or a wound that doesn’t heal or reopens may indicate acute or chronic infection.
Instability or feeling of “giving way”: A sensation that the knee is wobbling, buckling, or giving way while standing or walking suggests inadequate stability from the implant or surrounding tissues.
Significant stiffness or loss of motion: Difficulty bending or straightening the knee that does not improve with physical therapy.
Unusual noises: New or persistent clicking, popping, or grinding sounds may indicate mechanical wear or misalignment of implant components.
Sudden swelling or calf pain: This may be a sign of a Deep Vein Thrombosis (DVT) requiring immediate medical attention.

When to see an orthopaedic surgeon

It is advisable to contact your orthopaedic surgeon if you experience any of the persistent symptoms mentioned above. Early diagnosis of complications such as infection or mechanical loosening significantly improves the success rate of any required revision surgery.