Illustration of Ehlers-Danlos Syndrome patient holding a healthy knee joint, symbolizing pain relief and improved mobility.

Ehlers-Danlos and Knee Replacements: What You Need to Know

Theo Raines in Health & Wellness November 2025 • 4 min read.

"Navigating Total Knee Arthroplasty with Ehlers-Danlos Syndrome: A comprehensive guide to outcomes, considerations, and expert insights for patients and caregivers."

Ehlers-Danlos Syndrome (EDS) is a group of inherited disorders that affect connective tissues, primarily impacting the skin, joints, and blood vessel walls. These tissues provide strength and elasticity to the body, and when affected by EDS, can lead to a range of symptoms, most notably joint hypermobility, chronic pain, and an increased risk of dislocations.

For individuals with EDS, daily activities can be significantly impacted by joint instability and pain. When conservative treatments like physical therapy and pain management are no longer sufficient, total knee arthroplasty (TKA), or knee replacement surgery, may be considered. However, due to the underlying connective tissue disorder, TKA in EDS patients presents unique challenges and considerations.

Recent research has shed light on the outcomes of TKA in patients with EDS, providing valuable insights for both patients and surgeons. This article will delve into the findings of a key study, explore the specific considerations for TKA in the context of EDS, and offer guidance on navigating this complex decision.

What Does the Research Say About Knee Replacement and EDS?

Illustration of Ehlers-Danlos Syndrome patient holding a healthy knee joint, symbolizing pain relief and improved mobility.

A recent study published in The Journal of Arthroplasty investigated the outcomes of primary total knee arthroplasty in patients with Ehlers-Danlos Syndrome. The researchers compared 16 patients (20 knees) with EDS who underwent TKA to a matched control group of 40 patients (osteoarthritis patients) who had TKA for osteoarthritis (OA). The study meticulously analyzed various factors, including surgical interventions, component types, reoperation rates, and clinical outcomes.

The study revealed several key findings:

Constrained Components: Patients with EDS were more likely to require constrained knee components (VVC), which provide greater stability.
Prior Surgeries: EDS patients had significantly more prior surgical interventions on their knees before undergoing TKA.
Reoperation Rates: There was no significant difference in reoperation rates between the EDS and OA groups.
Knee Society Scores: Both groups demonstrated statistically significant improvements in Knee Society Scores (KSS) after surgery, with no significant difference between the groups at the latest follow-up.
Survival Rates: Overall survival rates of the knee replacements were similar between the EDS and OA groups.

These findings suggest that while patients with EDS may present unique surgical considerations, TKA can be a viable option for improving knee function and reducing pain. However, it's essential to delve deeper into the specific challenges and strategies for optimizing outcomes.

Making Informed Decisions About Your Knee Health

If you're considering TKA and have EDS, a thorough discussion with your orthopedic surgeon is paramount. Share your medical history, specific concerns, and expectations for surgery. Your surgeon can assess your individual needs, explain the potential risks and benefits, and develop a personalized treatment plan. Remember, with proper planning and a collaborative approach, TKA can be a positive step towards improving your quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.arth.2018.09.079, Alternate LINK

Title: Outcomes Of Primary Total Knee Arthroplasty In Patients With Ehlers-Danlos Syndromes

Subject: Orthopedics and Sports Medicine

Journal: The Journal of Arthroplasty

Publisher: Elsevier BV

Authors: Meagan E. Tibbo, Cody C. Wyles, Matthew T. Houdek, Benjamin K. Wilke

Published: 2019-02-01

Everything You Need To Know

What is Ehlers-Danlos Syndrome, and how does it affect the body?

Ehlers-Danlos Syndrome (EDS) is a group of inherited disorders affecting connective tissues, impacting the skin, joints, and blood vessel walls. These tissues provide strength and elasticity, and when affected by EDS, it can lead to joint hypermobility, chronic pain, and increased risk of dislocations.

What does recent research indicate about the outcomes of knee replacement surgery in individuals with Ehlers-Danlos Syndrome?

The research, as published in *The Journal of Arthroplasty*, indicated that while those with Ehlers-Danlos Syndrome undergoing Total Knee Arthroplasty (TKA) may require constrained knee components for greater stability and often have a history of prior knee surgeries, the overall survival rates of the knee replacements and improvements in Knee Society Scores (KSS) were similar to patients undergoing TKA for osteoarthritis.

What are constrained components (VVC) in knee replacement, and why might someone with Ehlers-Danlos Syndrome need them?

Constrained knee components, such as VVC, are used in Total Knee Arthroplasty (TKA) to provide greater stability. The study indicated that individuals with Ehlers-Danlos Syndrome (EDS) undergoing TKA were more likely to require these types of components due to the underlying connective tissue disorder affecting joint stability. Without them the surgery has an elevated risk of failure.

What steps should someone with Ehlers-Danlos Syndrome take to make informed decisions about knee replacement surgery?

Before undergoing Total Knee Arthroplasty (TKA), individuals with Ehlers-Danlos Syndrome (EDS) should have a thorough discussion with their orthopedic surgeon. It is important to share your complete medical history, specific concerns related to EDS, and realistic expectations for the surgery. A personalized treatment plan can then be developed, addressing the unique challenges presented by EDS to optimize outcomes.

Although the study mentioned similar outcomes between those with Ehlers-Danlos Syndrome and osteoarthritis following Total Knee Arthroplasty, what are some essential caveats or areas needing further investigation regarding these findings?

While the study showed similar survival rates and KSS improvements between Ehlers-Danlos Syndrome (EDS) and osteoarthritis (OA) patients after Total Knee Arthroplasty (TKA), it's crucial to acknowledge that these findings represent averages. The increased need for constrained components and the history of prior surgeries in EDS patients suggest a potentially more complex surgical landscape and recovery. Further research focusing on long-term outcomes specific to EDS patients is needed to fully understand the durability and potential complications associated with TKA in this population.