Can Knee Replacement Fail? Causes, Signs & Prevention

February 21, 2026

Knee replacement is one of the most successful orthopedic surgeries for relieving chronic knee pain and restoring mobility. Modern implants are designed to last many years, and with advanced techniques like robotic-assisted knee replacement, outcomes are more accurate and recovery is often smoother. Still, many patients understandably ask: Can knee replacement fail?

The honest answer is: Yes, failure is possible—but it is not common, and in many cases it can be prevented with the right surgeon, correct implant alignment, strong infection control, and proper rehabilitation.

In Faridabad, patients seeking advanced joint replacement care often look for expertise, technology, and proven outcomes. Dr. Deepak Mishra is widely regarded as the best orthopedic doctor in Faridabad and a leading robotic knee replacement surgeon, known for precision-driven knee replacement procedures and patient-focused recovery guidance.

What Does “Knee Replacement Failure” Mean?

A knee replacement is considered to have “failed” when the implant does not function as expected or causes persistent problems such as:

Ongoing pain that does not improve
Instability or repeated giving way
Stiffness or reduced movement
Infection around the implant
Implant loosening or wear
Need for a revision (repeat) surgery earlier than expected

Failure can happen early (weeks to months) or late (years later) depending on the cause.

How Common Is Knee Replacement Failure?

Most patients do very well after knee replacement, especially with appropriate planning and rehabilitation. Failures are uncommon, but the risk can increase due to medical conditions, lifestyle factors, infection, poor alignment, or trauma. Choosing an experienced surgeon and modern surgical planning (including robotic assistance) plays a major role in reducing avoidable risks.

Causes of Knee Replacement Failure

1) Infection (Early or Late)

Infection is one of the most serious causes of failure. It can occur soon after surgery or even months/years later if bacteria enter the bloodstream and settle around the implant.

Why it happens:

Diabetes not well controlled
Weak immunity
Poor wound healing
Untreated dental/urinary infections after surgery
Smoking, obesity, malnutrition

What patients may notice:

Redness, swelling, warmth
Persistent drainage from the wound
Fever or chills
Increasing pain after initial improvement

2) Implant Loosening (Aseptic Loosening)

Over time, the implant may loosen from the bone, even without infection. This can happen due to wear particles or poor fixation, leading to pain and instability.

Common triggers:

High body weight and high-impact activity
Poor bone quality (osteoporosis)
Malalignment (implant not perfectly positioned)

3) Poor Alignment or Improper Soft-Tissue Balancing

If the implant is not aligned correctly or the ligaments around the knee are not balanced well, the knee may feel unstable or painful.

This is exactly where robotic knee replacement can help—robotic systems assist in:

More accurate bone cuts
Better implant positioning
Better balancing of ligaments
Customized alignment planning

Patients often choose experts like Dr. Deepak Mishra, known as a best robotic knee replacement surgeon in Faridabad, for precision-based outcomes.

4) Instability (Knee “Giving Way”)

Some patients experience a sensation that the knee is slipping, giving way, or not supporting weight properly.

Possible reasons:

Ligament imbalance
Weak muscles due to inadequate physiotherapy
Incorrect implant size
Trauma/fall after surgery

5) Stiffness (Limited Knee Bending)

A stiff knee can occur when scar tissue forms excessively or physiotherapy is delayed.

Risk factors:

Limited knee movement before surgery
Poor pain control leading to avoiding exercise
Irregular physiotherapy
Scar tissue formation (arthrofibrosis)

6) Implant Wear (Over Years)

Knee replacement components can wear down gradually, especially with:

High-impact activities
Excessive weight
Long duration after surgery

Wear can lead to swelling, pain, and loosening.

7) Fracture Around the Implant (Periprosthetic Fracture)

A fall or trauma can cause a fracture around the replaced knee—more common in older patients or those with weak bones.

8) Allergy or Sensitivity (Rare)

A small number of patients can react to certain implant metals. This is uncommon but can cause pain and swelling without infection.

Signs and Symptoms of a Failing Knee Replacement

If you notice any of these, you should consult your orthopedic surgeon promptly:

✅ Pain-related signs

Persistent pain that doesn’t improve after the expected recovery phase
New pain after a pain-free period
Night pain or increasing pain while walking

✅ Mechanical signs

Clicking with pain
Knee giving way or instability
Difficulty climbing stairs (worsening over time)
Reduced walking distance compared to early recovery

✅ Infection warning signs

Redness, warmth, swelling around the knee
Fever, chills
Wound discharge or foul smell
Sudden increase in stiffness and pain

✅ Swelling and stiffness

Recurrent swelling
Progressive loss of knee bending

How Knee Replacement Failure Is Diagnosed

Your orthopedic team may recommend:

Clinical examination (stability, gait, range of motion)
X-rays (implant position, loosening, fracture)
Blood tests (infection markers like ESR/CRP)
Joint fluid aspiration (to check infection)
CT scan in select cases (alignment/rotation assessment)

Early diagnosis matters because many problems can be treated more easily when caught early.

Prevention: How to Reduce the Risk of Knee Replacement Failure

1) Choose the Right Surgeon (Most Important)

Surgeon experience, planning, and technique significantly affect success. In Faridabad, many patients prefer Dr. Deepak Mishra because he is recognized as the best orthopedic doctor in Faridabad and among the best robotic knee replacement surgeons, especially for patients seeking advanced precision and reliable outcomes.

2) Consider Robotic Knee Replacement for Accuracy

Robotic assistance helps achieve:

Better alignment
Better implant sizing
Better ligament balance
These factors reduce complications like early wear, instability, and pain.

3) Control Medical Risk Factors

Before surgery, optimize:

Diabetes (HbA1c under control)
Blood pressure
Nutrition (protein levels)
Weight management
Stop smoking and tobacco use

4) Strict Infection Prevention

Keep wound clean and dry
Follow antibiotic instructions
Treat dental/urinary infections promptly
Inform your doctor before invasive procedures

5) Take Physiotherapy Seriously

Rehab is not optional. It prevents stiffness and strengthens muscles that support the implant.

Key goals:

Early walking as advised
Quadriceps strengthening
Range-of-motion exercises daily
Regular follow-ups

6) Avoid High-Impact Activities

Once recovered, prefer:

Walking
Cycling
Swimming
Low-impact strengthening
Avoid repetitive running/jumping unless your surgeon specifically allows it.

7) Prevent Falls

Especially for seniors:

Use assistive support when needed
Improve home safety (anti-slip mats, bathroom handles)
Check vitamin D/bone health

What If a Knee Replacement Fails?

Treatment depends on the cause:

Physiotherapy + medications (for mild stiffness/pain)
Procedures to remove scar tissue (if stiffness is severe)
Antibiotic treatment (for infection, sometimes staged surgery needed)
Revision knee replacement (if loosening, instability, or severe wear)

Revision surgeries are more complex, so prevention and early evaluation are always better.

When Should You See an Orthopedic Doctor Immediately?

Seek urgent consultation if:

You have fever + knee swelling/pain
Wound is leaking fluid
Knee suddenly becomes unstable after a fall
Pain worsens rapidly after initial recovery

Conclusion

While knee replacement is highly successful, failure can occur due to infection, loosening, improper alignment, instability, stiffness, wear, or trauma. The good news is that most risks can be minimized through expert surgical planning, robotic precision, infection prevention, and disciplined rehabilitation.

If you are considering knee replacement or are worried about post-surgery symptoms, consult a specialist early. In Faridabad, Dr. Deepak Mishra is regarded as the best orthopedic doctor in Faridabad and one of the best robotic knee replacement surgeons, trusted for advanced joint replacement techniques and patient-centric care.

FAQs

1) Can knee replacement fail within 1 year?
Yes, but it’s uncommon. Early failures are usually due to infection, instability, or stiffness.

2) How do I know if my implant is loose?
Pain during walking, swelling, and a feeling of instability can be signs. X-rays help confirm.

3) Can physiotherapy prevent failure?
Physiotherapy can’t prevent all causes, but it strongly reduces stiffness and improves long-term function.

4) Does robotic knee replacement reduce failure risk?
It can reduce risk related to alignment and balancing, which may improve long-term outcomes.