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What causes swelling in the right knee post a partial knee replacement surgery?

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Posted on Wed, 10 May 2017
Question: Partial knee replacement in right knee, surgery was March 2013 at age 30. Replacement was done due to a cracked knee cap and deteriorated cartilage. Not sure if related, but at 25 I had both hips resurfaced and femoral heads reshaped.

In the last 8 months I am dealing with a significant amount of swelling in my right knee that is painful to the point of being completely immobile and unable to bend knee. Operating surgeon has drained knee 4 times since Sept 2016. Amounts drained range from as low as 60cc to 150cc. Finally did a culture of the knee fluid and a cell count of over 10,000 came back but my doctor insisted that was lab error, we did another culture and they have not called back or returned my calls so I assume all is ok? I am not able to get in any sooner than the end of XXXXXXX but honestly cannot take this pain anymore and figured another opinion could not hurt.

We have done x-rays to check implant and that looks good. The MRI has shown no tears. However I am still in a lot of daily pain and daily swelling. I figured my weight was a problem 5'7" and WAS 212 pounds but now I have lost 23.4 pounds in hopes to relieve the issues and still no changes.

At my age I assume I am to just deal with this awful swelling? I do know barometric pressure does play a roll, I have been keeping track on my calendar. I would like to reduce my obvious limp, I have paid for PT out of pocket in hopes this was a strength issue, but no changes. Currently I am taking tramadol for pain, been on it daily for several months now. I have tried ice, heat, hot tub soaks, compression wraps, icy hot, elevate. Only think that has ever shown to work is literally doing NOTHING for a few days, I cannot live with my butt on the couch, I just can't.
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Answered by Dr. Mahaveer Patil (1 hour later)
Brief Answer:
SEEMS TO BE SYNOVITIS

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

From the symptoms,it seems that there is a reactionary synovitis of the knee joint,either due to the implant itself,or due to wear and tear of the remaining cartilage.

I think the main cause could be body weight.Increased axial pressure on the implant and the knee cases reactionary synovitis of the synovium causing the fluid to accumulate within the knee cavity.

Another possibility is a low grade synovial infection.

If the synovial fluid examination was abnormal,then the infection needs to be cleared by taking antibiotics,especially broad spectrum antibiotics.

It is good that you have lost weight but you should still lose some more.

I suggest you to wear a knee brace or a knee cap around the knee .

Consult a ER if the pain is severe.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Wish you a speedy recovery.

Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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What causes swelling in the right knee post a partial knee replacement surgery?

Brief Answer: SEEMS TO BE SYNOVITIS Detailed Answer: Hi, Thank you for posting the question. I have gone through your medical history in detail. From the symptoms,it seems that there is a reactionary synovitis of the knee joint,either due to the implant itself,or due to wear and tear of the remaining cartilage. I think the main cause could be body weight.Increased axial pressure on the implant and the knee cases reactionary synovitis of the synovium causing the fluid to accumulate within the knee cavity. Another possibility is a low grade synovial infection. If the synovial fluid examination was abnormal,then the infection needs to be cleared by taking antibiotics,especially broad spectrum antibiotics. It is good that you have lost weight but you should still lose some more. I suggest you to wear a knee brace or a knee cap around the knee . Consult a ER if the pain is severe. I hope the answer was useful. Feel free to ask me any follow up queries that you may have. Thank you. Wish you a speedy recovery.