Pain after knee arthroplasty- we help you!

A considerable number of patients are not satisfied or pain free after partial or total knee replacement. About 1/4 to 1/3 of patients are not happy after knee replacement surgery.

 

In the early years of knee replacement surgery it was the aim to achieve a pain free knee, which allows the patient to ambulate. Today patients`expectations are much higher than in these early days. Most of the patients expect to have a pain free, stable knee with good range of motion. Besides daily activities a high percentage of patients also want to perform sports such as running, tennis, soccer or skiing.

 

Main complaints after TKR are typically:

1. Persistent or recurrent pain

2. Stiffness

3. Limited range of motion

4. Infection

 

As cause of the problems a variety of diffferent reasons can be considered.

 

 

The cause(s) of the patients`pain or problems are numerous. A single or a combination of causes can be responsible.

Typically one distinguishes knee related from non-knee related reasons.

 

The most common knee-related problems are:

Malposition of knee replacement components

Infection

Loosening and wear of prosthesis

Stiff knee joint (arthrofibrosis)

Patellofemoral problems

Extensor mechanism insufficiency

Soft tissue impingement

 

The most common non-knee related problems are:

Vascular problems such as deep vein thrombosis

Osteoarthritis of hip joint

Spinal stenosis

Neurological problems such as neuroma

Complex regional pain syndrome

 

In addition, all problems can be aggravated by psychological factors such as anxiety, depression, patient`s expectation or self-efficacy. 

 

Patients, which present to our specialised knee clinic "Painful knee replacement" need to undergo a detailed, individually tailored clinical and radiological diagnostic.

 

 

Typically the main complaints and symptoms of the patients are complex. The diagnostical evaluation is difficult and should be performed in a standardised manner following a diagnostic algorithm. 

 

Only if the cause(s) of the problems are unambigously identified, there is a chance of improvement, whether treated surgcially or non-surgically.

In the case of persistent pain (> 12 months), stiffness or limited range of motion a second opinion of a specialised knee surgeon is indicated.

In the case of infection (swelling, erythema, warm knee joint) an urgent consultation is necessary.