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This video, courtesy of a talented South African orthopedic surgeon, explains why a total knee replacement, however well done, may lead to negative outcomes for patients. I am one such patient, primarily due to hypermobility of ligaments which my US based surgeon failed to diagnose prior to total knee replacement. Other contributing factors are gender (female) and flat feet. Had my hypermobility been diagnosed before surgery, albeit a combination of factors that appears somewhat rare, I might not have been considered a good candidate for total knee replacement and/or the knee replacement surgery would have almost certainly included patella resurfacing. A cautionary tale and one which may interest physical therapists who are finding that some patients are unable to fully recover from total knee replacement. My only recourse, unless I am willing to accept a fairly sedentary lifestyle, is to go back into surgery to have the patellas thinned and resurfaced.