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Total knee replacement surgery done. Leg is unstable. What treatment should I do to get cured?

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Orthopaedic Surgeon
Practicing since : 1994
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I had a TKR 2 years ago. I am 40 years old, The leg is very unstable. Got a second opinion and was told that
the knee was no good, the doctor will not do anymore surgery because the HTO I had before the TKR was 20 degress valgus and a revision would not work. What are some options that I be able to have, I am a Soldier and very active.

Kind Regards,
Posted Fri, 17 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 42 minutes later
Thanks for posting your query.
High tibial osteotomy is done in knee joint deformity to redistribute the body weight to all the compartments of the knee and a valgus is produced to get the result. Gradually the knee joint becomes accustomed to the redistributed weight.
A Total knee replacement after HTO can lead to an unstable knee.
The options you have now are-
1. mechanical support by brace/ orthotics
2.preventing overuse-by lifestyle modification.
3.improving muscle balance-by selective muscles strengthening,
4.artificial lubrication-injecting synthetic fluid similar to what natural knee makes.
You can discuss all these options with your orthopedician and start with knee stabilizing exercises under the guidance of a proficient physiotherapist.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Total knee replacement surgery done. Leg is unstable. What treatment should I do to get cured? 44 minutes later
Doctor the comment you gave me was the pit fall of any answer.
Maybe the reply may have been a hinged TKR.
I am 40 Years old and can not wear a brace for another 40 years, may be at this time being a young age even a AMPUTATION would be a great thing as the old you get the harder it is to walk with a fake leg.
Answered by Dr. Praveen Tayal 6 hours later
Thanks for writing again.
A rotating hinge TKR or a revision TKR are the options but these are not likely to be too successful in an unstable knee.
Selective muscle strengthening can help in reducing the instability to some extent.
The best options can be suggested only after a clinical examination and after assessing the degree of instability.
Amputation is not an answer to your problems. Please do not feel disheartened.
I am sure you can find yourself in a better position with the help of a physiotherapist.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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