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Had a partial knee replacement. Still having pain while walking. Not responding to Lidocain shot. Need to go for total knee replacement?

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Orthopaedic Surgeon, Joint Replacement
Practicing since : 1991
Answered : 20 Questions
knowing if knee replacement would helpYes last July I had a partial knee replacement. It is still very painful to walk my doctor gave me a lidocain shot and wants me to let him know how I feel. I got no relief from shot so does this mean converting it to a total knee replacement would help take pain away.
Posted Fri, 13 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Deepak Goyal 2 hours later

Thank you for posting your query.

I have gone through your query and I understand your concern.

To be able to give you an appropriate guidance I would like to know a few more details about your condition and yourself. Hence I request you to answer the following.,

1. What is your age?
2. What was the indication for Partial Knee replacement?
3. What is present status? X-ray of your present knee can be very informative, hence I request you to kindly utilize the attach reports option which is provided on the right hand side of your dashboard page.
4. What is your Body Mass Index (weight and height)? and
5. Do you suffer from any diseases like diabetes, hypertension etc,?

Generally Unicompartmental Knee Arothroplasty(UKA) are less successful as against Total Knee Arthroplasty(TKA).

If it is a true Partial Knee failure, than Total Knee Replacement is the answer.
But before that lot need to be investigated and found out.

Please write back with the answers so that I can suggest you better.

Awaiting your response.

Dr Deepak Goyal.
Consultant Knee Joint Surgeon.
Above answer was peer-reviewed by
Follow-up: Had a partial knee replacement. Still having pain while walking. Not responding to Lidocain shot. Need to go for total knee replacement? 48 hours later
i am 45 and all i know is i have arthritis no other health issues i am overweight by about 40 pounds which i am loosing. i would just like to know purpose,of giving me a shot of lidocain and if it helped take away the pain but only for a few hours what does that mean
Answered by Dr. Deepak Goyal 19 minutes later
Hello, thank you for writing back

Lidocaine is short acting local anesthetic agent. That means it will make your tissues numb for few hours. If mixed with certain agents than its effect can last somewhat longer. But never in weeks or days. Purpose can be to provide temporary pain relief or to differentiate between true local source of pain Vs Functional source of pain.

In any case, lidocaine is no definite treatment. You need to get yourself examined completely by Knee Surgeon and find out the actual problem. Than and than your problem can be treated.

Hope I have answered your query completely. Please write back if you have additional concerns.

Best wishes.

Dr Deepak Goyal
Above answer was peer-reviewed by
Follow-up: Had a partial knee replacement. Still having pain while walking. Not responding to Lidocain shot. Need to go for total knee replacement? 1 hour later
yes the doctor that gave me the shot said this would determine if knee replacement woud help . what i want to know is because the lidocain helped take most of the pain away fora few hours does that mean a knee replacement would or would not be a good idea so bascially does it mean that the lidocaine working for a few hours mean that,my pain is more related to muscle and tissue pain and that replacing the knee will not help with my pain
Answered by Dr. Deepak Goyal 10 hours later

I do not agree that +ve Lidocaine shot means, you will benefit from TKR (Total Knee Replacement). It may be true, but it may be too much for the small problem.

We need to exclude infection, implant loosening, status of ligaments, status of PF joint and lateral joint. You need to have Standing x-ray of your knee, Bone scan in addition to other routine blood profile. Investigation list can go further, once patient is examined by a qualified doctor.

Lidocaine works on all tissues with pain fibers. So +ve Lidocaine only means that the tissue that received the shot is cause of pain. But still it is very vague, as it was given by GP (General Physician) and not knee specialist.

Dr Deepak Goyal
Above answer was peer-reviewed by
Follow-up: Had a partial knee replacement. Still having pain while walking. Not responding to Lidocain shot. Need to go for total knee replacement? 5 hours later
i have,had blood work and bone scan and there is no infection. i do hsve arthritis and the doctor giving me the shot is a,knee,surgeon. i was told by his partner a tkr would take my pain away but then he gave me this shot to see how i felt. it took most of pain away but knee still hurt so with that said does that mean it is a soft tissue pain and tkr would,or would not help
Answered by Dr. Deepak Goyal 50 minutes later
Hi and thanks again,

I understand your concern and appreciate your efforts in seeking help here. I also understand your concerns and your wish to know whether or not total knee replacement will be help you.

First let me tell you this, we may not be able to decide if you are a candidate for total knee replacement based on lidocaine shot alone. Pain relief following lidocaine only tells us that the site (ligaments, tendons, soft tissue or the synovial fluid) to which the drug was injected were affected and that needs to be corrected. Most often as you rightly guessed it could be a soft tissue inflammation that needs treatment; you may not need another surgery. However, only your doctor who evaluated you and administered this drug can tell us more about it.

As far as total knee replacement is concerned, we need to analyze your current knee status by a careful physical examination, X rays, bone scan and other investigations before embarking on replacing the knee totally. With limited clinical details and without the opportunity to physically examine you, it would not be ethical and appropriate to suggest you the treatment. I would encourage you to discuss about these with your current knee surgeon. You can also take another opinion from a second knee surgeon near your locality if you are not happy with the present one.

I apologize if my answers were not complete and I hope my answer is bit useful; atleast in guiding you to take the next step towards treatment. Let me know if you have more concerns.

Wish you good health.

Best of luck
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