A knee replacement that continues to hurt, feels unstable, or has become stiff is a genuine problem — and it deserves proper investigation rather than reassurance. Some causes are treatable without further surgery; others need revision.
Dr. Vaibhav Bagaria assesses failed and painful knee replacements at Sir H. N. Reliance Foundation Hospital, Mumbai, and performs revision knee replacement. The first step is always to establish why the knee is failing, because revision without a clear diagnosis rarely resolves the symptoms.
A knee replacement is described as failing when it no longer provides the pain relief or function it should. This may present as persistent pain, stiffness, instability, swelling, or a change in how the knee feels after a period of working well.
Failure is not always mechanical. A knee may be structurally sound and still painful. Establishing the cause is the central task, and it determines everything about treatment.
Infection may occur early after surgery or years later, sometimes from bacteria spreading through the bloodstream. This must be excluded in every painful replacement.
The implant loses its fixation to bone over time, making loosening one of the more common causes of late failure.
The plastic bearing surface wears with use over many years, which can contribute to bone loss and implant problems.
Soft tissue balance around the knee may be inadequate, causing a sensation of giving way or instability.
Scar tissue can restrict movement, sometimes following limited early rehabilitation.
Components positioned outside the intended range can cause pain and accelerate wear.
A periprosthetic fracture can occur around the implant, usually after a fall.
Hip arthritis and lumbar spine problems can both refer pain to the knee and may sometimes be the actual source of symptoms.
Seek urgent care for a hot, red, swollen and severely painful knee with fever — this may indicate infection of the implant, which needs prompt treatment. Also seek urgent assessment for sudden inability to bear weight, or severe pain and deformity after a fall, which may indicate fracture around the implant.
When the original surgery was done and by whom, whether the knee was ever comfortable, how the pain began, any wound problems after the original surgery, recent infections or dental work, and any falls.
Range of movement, stability, alignment, wound and scar assessment, effusion, warmth, and examination of the hip and lumbar spine to exclude referred pain.
Knowing exactly which implant was used significantly affects revision planning.
Where no mechanical or infective cause is found, or where symptoms are manageable:
Where there is confirmed loosening, significant wear, instability, infection, fracture around the implant, or persistent pain with an identified mechanical cause.
Revision is not advised where no cause has been identified. Operating on an unexplained painful knee replacement frequently fails to resolve the pain.
Revision surgery is more complex than the original replacement. Bone loss, scar tissue and altered anatomy mean it takes longer and recovery is generally slower.
Failed hip replacement
Knee arthritis
Post-traumatic arthritis
Over two decades of orthopaedic surgical
experience
Internationally fellowship-trained in the USA,
Germany and Australia
Surgery recommended only when it is
genuinely the better option
Among India's earliest robotic joint
replacement surgeons
150+ peer-reviewed publications and multiple
device patents
Structured rehabilitation planned before the
operation, not after
Dr. Vaibhav Bagaria is Director and Head of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, and one of the earliest surgeons in India to adopt robotic joint replacement. Over twenty-two years of practice he has treated patients across the full range of bone and joint conditions, with a particular focus on robotic knee and hip replacement, partial knee replacement, sports injury and arthroscopy, and complex pelvic and acetabular reconstruction.
Name
Dr. Vaibhav Bagaria
Experience
20+ Years
Qualifications
MS (Ortho) FASSI, FNUS, FNAMS..
Speciality
Practice
Schedule your consultation with Dr. Vaibhav Bagaria today
Dr Vaibhav Bagaria
Prarthana Samaj, Khetwadi, Girgaon,
Mumbai, Maharashtra 400004
02261305757
