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Persistent knee pain. History of knee replacement. Should I consider another knee replacement?

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Posted on Thu, 12 Jul 2012
Question: I have had knee replacement one year ago, now after one yr it still hurts like pressure in my knee, and my lymnoids are swollen in my hip same side as my knee replacement , left knee, Dr says another knee replacement may be needed by putting in a different plate and narrowing it to 8mm and trimming any scar tissue that may be pressent..he said another six weeks off work, if i could get knee to keep from swelling I could put it off for a couple of minths and maybe save my job, but nids seem to b e getting bigger..any suggestions

my primary Dr told me this was normal with knee pain, and since im not expericnceing any fever no anitbotis were issed,,just mobic to help with pain and swelling
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Answered by Dr. Praveen Tayal (6 hours later)
Hello,
Thanks for posting your query.
Persistent pain 1 year after total knee replacement can be due to neuropathic pain, XXXXXXX scarring (arthrofibrosis), loosening of the prosthesis, patellofemoral instability, postoperative stiffness, etc.
A direct clinical examination and investigations like MRI and arthroscopy are needed to identify the exact cause. The treatment usually involves pain killers under guidance of a pain therapist, physiotherapy, occupational therapy, etc.
Usually a second surgery is not needed. Physiotherapy and removal of any extra scar tissue by arthroscopy is helpful.
Conservative treatment includes-

1.mechanical support by brace/ orthotics.
2.preventing overuse-by lifestyle modification,
3.releasing the tight scar tissue-by XXXXXXX frictional massage,
4.improving muscle balance-by selective muscles strengthening,
5.relieving local inflammation/painkillers-for temporary use, and finally
6.artificial lubrication-injecting synthetic fluid similar to what natural knee makes.

Since your knee symptoms are flaring up, I suggest you consider visiting your physical therapist soon. Most of the aforesaid options will be readily available there.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12328 Questions

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Persistent knee pain. History of knee replacement. Should I consider another knee replacement?

Hello,
Thanks for posting your query.
Persistent pain 1 year after total knee replacement can be due to neuropathic pain, XXXXXXX scarring (arthrofibrosis), loosening of the prosthesis, patellofemoral instability, postoperative stiffness, etc.
A direct clinical examination and investigations like MRI and arthroscopy are needed to identify the exact cause. The treatment usually involves pain killers under guidance of a pain therapist, physiotherapy, occupational therapy, etc.
Usually a second surgery is not needed. Physiotherapy and removal of any extra scar tissue by arthroscopy is helpful.
Conservative treatment includes-

1.mechanical support by brace/ orthotics.
2.preventing overuse-by lifestyle modification,
3.releasing the tight scar tissue-by XXXXXXX frictional massage,
4.improving muscle balance-by selective muscles strengthening,
5.relieving local inflammation/painkillers-for temporary use, and finally
6.artificial lubrication-injecting synthetic fluid similar to what natural knee makes.

Since your knee symptoms are flaring up, I suggest you consider visiting your physical therapist soon. Most of the aforesaid options will be readily available there.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.