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After my total knee replacement I went through a long recovery process. It wasn’t easy, but I am grateful that my rehabilitation was successful.
I hoped it would be the first and last TKR I would need, and up to this point, I’ve only required one. I put off TKR for a long time because I wanted the procedure to last the rest of my life.
Unfortunately, some people will need more than one knee replacement. However, it’s not uncommon for people to have the surgery done multiple times.
In this article I will discuss several reasons why you may need additional TKR surgery or what is known as a “revision”. For most people TKR is a positive, life changing experience, but a small percentage of people develop complications.
Is It Common To Have Multiple Knee Replacements
The answer to the above question is “no”. Studies show that 85 to 90% of patients have good success with their initial knee replacement for 15 to 20 years.
Most knee replacements will last 20 years or more if you do not have complications.
I had my TKR at the age of 66, and many people have TKR surgery at a much younger age. A knee replacement at a younger age may increase their chance of needing a repeat TKR procedure at some point in their life.
Health and work-related issues may increase your chances of additional knee surgeries. If you are overweight, or continue to do heavy manual work, or if you continue to engage in high-impact exercise (like running and sports) that puts added stress on your knee, it may cause your implant to wear out early.
Age is a major factor when considering a knee replacement. Many people wait as long as they can to have TKR hoping it will last a lifetime.
Many younger patients are not able to wait until they are older so they opt to have TKR in their 40’s or 50’s. Younger patients are more likely to need a second TKR because their implant will eventually fail as they age.
- Your weight can play a big role in how long your implant lasts. In general, the less weight and stress you put on your new knee, the longer it will last.
- Your level of activity may also cause your TKR to fail early. The more stress and impact you put on your knee the earlier it may wear out.
- Surgical mistakes, which are few can also create a need for a “revision” or another TKR.
My Perspective On TKR: Would I Be Open To Another Knee Replacement
As I mentioned earlier, I put off TKR until I could no longer deal with the pain. I was 66 years old.
My hope and prayer is that I only have one TKR in my lifetime, partly due to the major surgery and the long recovery process (I feel great now, but recovering from surgery wasn’t a walk in the park).
If my implant fails early and does not last my lifetime, there will several factors I will consider before having a second TKR. The factors will include:
- My age (read my article about age and knee replacement)
- The pain I am feeling
- My ability to rehab
- Will it improve my quality of life by having a second TKR.
The recovery process from TKR is of the utmost importance. The mind and the body need to be well-prepared.
I would need to be in good physical health in order to complete the physical therapy. I would need to be psychologically ready to endure the necessary pain that accompanies rehabbing after TKR.
How Many Knee Replacements Can You Have
Most people whom I have met only had one knee replacement surgery. Several other friends and acquaintances have had two, one on each knee.
You can have several knee replacements in a lifetime. Many people will have 2 knee replacements if they had their first knee replacement at an early age (they last 10-15 years). Few people will have 3 knee replacements in a lifetime, however, it is possible to have more.
One friend who I play pickleball with had 4 surgeries on the same knee in the last 5 years. I will share some of the reasons why this might occur.
He had his first TKR at age 58. He was very fit at the time and he looked forward to relieving the pain he felt in his knee and improving the overall function of his knee.
After his first TKR he experienced a heart attack in the hospital during his post-operative recovery (he had no prior heart problems). Needless-to-say he stayed in the hospital longer than he expected and his knee replacement rehab was postponed for several days.
He recovered well from TKR and the heart attack, then he worked hard on his rehab. Even though his knee became stronger, it never felt quite right after the surgery.
A few months after the surgery, his knee became infected and he had a second surgery to “clean out” the knee.
He rehabbed again but he still encountered problems with his knee. A year later a new physician advised him that the first doctor misaligned the implant and he would need to have a “revision” (a revision is the replacement of a failed total knee prosthesis with a new prosthesis).
He was disappointed but had the 3rd surgery and rehabbed with good results (read my article about things you need for TKR rehab). After 4 months, he was back to his pre-surgery exercise routines as well as playing pickleball 2-3 times a week.
A year later while taking a shower, he noticed his leg bleeding from the incision. He consulted with his doctor again. His doctor advised him that he had significant scar tissue and a resulting infection.
This problem led to a 4th surgery. It has been 7 months since his last surgery. At age 62 he has had a total of 4 operations (two knee replacements and two infections which required surgery).
He is playing pickleball again and he is very mobile, even after experiencing complications with his recovery.
His story is certainly an exception to most knee replacements. He was active, fit, not overweight with no pre-existing health issues, yet he still experienced obstacles and overcame them.
Tips To Take Care Of your Knee: Make It last A Lifetime
As I have mentioned in many of my articles, being fit and reducing excess weight will reduce the stress on your new knee.
Regular exercise and stretching are a must, especially after completing your formal physical therapy.
Also, explore low-impact exercise and activities that keep you moving. Try hard to maintain your knee strength and range of motion. Stretch every day!
There are many low impact activities to choose from (ready more about activities to avoid after knee replacement).
Swimming is my first choice.
Biking outdoors or on a stationary bike are also great activities for health but easy on the body.
Walking and hiking are healthy alternatives as long as you don’t overdo it with excessive miles.
Massage has been very beneficial for me. I get a massage twice a month and I routinely use my electronic massager around my knee joint.
Conclusion
There are some things that you cannot control when deciding to have TKR. The surgery will likely go as expected but you could also experience challenges with infection or require a “revision”.
There are things you can do to prepare for surgery to reduce the chance of setbacks.
First, choose a doctor with a good reputation for success.
Your age, activity level, your weight and diet, as well as surgical mistakes are out of your control and can all contribute to a TKR failure.
You can prepare and make sure you are physically fit before your TKR. Your attitude and hard work during rehab can also make a big difference (it’s not easy to stay positive).
Remember, the vast majority of TKRs are a success. It can reduce or eliminate knee pain and improve your quality of life. Consider what you can do to insure the best results for your TKR.
If you require additional knee replacement surgeries keep an optimistic outlook and work with your doctor to ensure a successful outcome..