Pain And Other Physical Complications
Knee replacement surgery can result in physical complications ranging from pain and swelling to implant rejection, infection and bone fractures.
Pain may be the most common complication following knee replacement. Its normal for patients to experience some degree of pain up to six months after surgery. But if pain persists past six months after the procedure, its generally considered to be long-term, or chronic, pain.
Several studies have looked at the frequency of chronic pain among total knee replacement patients. Findings suggest anywhere from 16 percent to 44 percent of patients are reporting this side effect.
It is also possible that the true prevalence of chronic pain after TKA is even higher than estimated in research studies, as some patients may be reluctant to report that they have pain, authors of a 2018 article published in EFFORT Open Reviews wrote.
Knee Replacement Loosening Symptoms
How Long Does Pain Last After Total Knee Replacement
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What Is The Recovery Time After Knee Revision Surgery
It varies, but in most cases, physical therapy will be initiated within 24 hours of the procedure and will continue for up to three months.
Some patients take longer to recover. In some cases, protective weightbearing or limiting the knees range of motion is needed to promote appropriate healing. Therapy will usually continue for up to three months following the surgery. Assistive devices, such as a walker or crutches, will be used early in the convalescence period, and patients will progress to a cane or walking without any assistance as their condition improves.
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What Not To Do After Knee Replacement
After undergoing a partial or total knee replacement, there are certain movements to refrain from to avoid re-injuring your knee or causing pain.
Avoid any risk of falling; After knee surgery, it will take a while before you regain strength and balance in the leg, making you more likely to experience a fall. Avoid activities like climbing ladders and take care to hold on to handrails when using stairs. Hiking or walking on the uneven ground should also be avoided until your knee is properly healed.
Dont sit for long periods; Sitting for long periods after knee replacement surgery is correlated with a higher risk of blood clots. Make sure youre getting enough light activity to support healing after your operation.
Running; Running puts three times the amount of pressure on the knee as walking. Avoid running while youre healing from knee replacement surgery until cleared to do so by your doctor.
Knee Replacement Pain After Three Months
Swelling and bruising can continue for three months or more following knee replacement surgery. However, it varies from patient to patient and depends on the condition you were in before surgery. Many patients are back to their activities without the pain they had before surgery by this stage of recovery.
If you find that any movement or activity is still exceedingly painful after three months, you may be experiencing chronic pain. Chronic pain is defined as pain persisting for three months or longer. Its a condition that affects roughly 20% of knee replacement surgery patients. It can develop and increase in intensity in the weeks and months following surgery. This can have a huge impact on your overall quality of life. Talk to your doctor for help.
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Surgery Is Usually The Last Option
When a hip or knee has worn out and no longer functions as it should, medications, physical therapy, various injections, and other nonsurgical treatments can only do so much often they cant do much at all. For those who are healthy enough to have major surgery , total joint replacement is often the only option that offers a good chance at significant pain relief and improved function. Joint replacement surgery for arthritis is considered a treatment of last resort. But even though replaced joints may not last forever, they may last longer than wed thought.
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How To Encourage Healing
For anyone who has had knee surgery, it is essential to keep the wound as dry as possible until it has thoroughly healed. Covering the wound with a bandage will also help prevent irritation from support stockings and other clothing.
Having a healthful, balanced diet helps encourage healing, though a person may have a poor appetite for the first few days after their surgery.
The AAOS recommends exercising in the first few weeks after the operation. A physical therapist may recommend specific exercises that help restore movement and build strength in the knee, and a person may need to do these several times a day.
Otherwise, the best approach to aftercare largely depends on the type of surgery that a person has had.
Anyone who has undergone arthroscopy should exercise regularly. A doctor or physical therapist usually recommends 2030 minutes of exercise two or three times a day and walking for 30 minutes two or three times a day during early recovery.
A physical therapist may design a personalized activity program. This may involve gradually increasing the amount of walking and a timetable for resuming everyday activities, such as climbing stairs. They will also recommend rehabilitation exercises.
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Who Performs Knee Replacement Surgery
If you need knee replacement surgery, then an orthopedic surgeon is the type of doctor you must see. Here at Orthopedic Associates, we offer a range of doctors, physical therapists, and sports medicine specialists to help you manage the pain and recover as effectively as possible.
Our team offers three knee replacement surgeries:
- Total Knee Replacement Surgery
- Partial Knee Replacement Surgery
- Revision Knee Replacement Surgery
Additionally, we have other joint replacement procedures for different types of sports medicine injuries and other orthopedic concerns:
- Reverse Shoulder Joint Replacement Surgery
- Shoulder Joint Replacement Surgery
- Direct Anterior Hip Replacement Surgery
- Partial Hip Replacement Surgery
New Hip And Knee Replacement Data
A recent study examined how long knee or hip replacements last, and how their durability is affected by the persons age at the time of surgery. As published in the April 2017 edition of the medical journal The Lancet, researchers found that:
- Among more than 60,000 people who had a hip replacement, only 4.4% required revision surgery in the first 10 years after surgery, but by the 20-year mark, 15% required revision.
- Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery; by 20 years, 10.3% required revision.
- Age did matter. Of those over 70 having hip or knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%. But this risk was much greater in younger individuals, especially for men. Up to 35% of men in their early 50s required a second operation.
Some orthopedic surgeons might scoff at these findings and say, “My patients do better than those in in this study.” And that may be true. But increasingly, hospitals and surgeons are being required to make public their results, so if youre considering hip or knee replacement and your surgeons results are truly better, or worse, than average, hopefully youll be able to find out.
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Try To Recover Using The Least Possible Pain Medicine
The first 7-10 days after surgery, you will be struggling with chemical pain induced by the trauma that your knee has undergone. ;Marines, and other really tough guys get humbled by this pain and you do yourself a grave disservice to try to muscle through this period. You will waste valuable time feeling poorly and will have limited success advancing your range of motion, the most improtant goal. This tactic will also ;ensure that you are;taking narcotic pain medication for a longer period.
However if you take your pain meds as prescribed, and work hard, you can be off narcotic pain medicine ;in two weeks or at least by the time you finish gaining back your range of motion. Gotta get the range then you can back off pain medicine.
Overview Of Knee Revision Surgery
The first step is removal of the existing implant. If there has been significant bone loss, bone grafts may be required to fill these voids. Bone grafts can be either autografts or an allograft . In some cases, metal wedges, wires or screws may be used to strengthen the bone.
Finally, specialized revision knee implants are inserted. Temporary drains may be placed to help prevent excessive swelling of the knee and are usually removed a few days after surgery. Additionally, specialized negative pressure incisional dressings are also frequently employed to improve wound healing as they have been shown to decrease post-operative wound complications in high risk patients. These dressings are usually connected to a small portable pump that stays on for about a week and keep the wound protected and dry.
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A New Study Provides New Estimates
In February 2019, two large analyses were published in the medical journal Lancet regarding the longevity of replaced hips and knees, that included nearly 300,000 total knee replacements and more than 200,000 total hip replacements. They found encouraging results:
- Nearly 60% of hip replacements lasted 25 years, 70% lasted 20 years, and almost 90% lasted 15 years.
- Total knee replacements lasted even longer: 82% lasted 25 years, 90% lasted 20 years, and 93% lasted 15 years.
These estimates are quite a bit higher than prior ones and may reflect improvements in surgical technique and materials, general medical care around the time of surgery, or more aggressive mobilization and physical therapy that starts right after surgery. The study authors also suggest that these numbers reflect real life patients , rather than a small number from a single medical center.
Some caveats are worth noting:
- These surgeries were performed in New Zealand, Australia, Denmark, Finland, Norway, and Sweden. The results might be different in the US or other countries.
- Detailed information was not available regarding which patients were considered eligible for total joint replacement and which were denied surgery because they were considered at high risk for failure or complications. These factors can affect the success of joint replacement surgery.
Solutions To Knee Pain And Swelling From Joint Replacement Surgery
Once the patient understands the mechanical reasons for why pain and swelling continue to linger eight weeks after the operation, that individual will psychologically be better able to tolerate the pain and the visibility of the edema.
They will no longer fear that something went wrong or that the surgeon left something in there.
Quite frankly, the knee pain following a joint replacement can be brutal. Some patients have described it as the worst pain to have.
Additionally, every patient is different with regard to their tolerance for pain, says Dr. Bergin.
While one patient might take pain pills for about a week after their surgery, another patient might need them for longer.
Each physician must make a decision with regard to their patients experience of pain, based on their knowledge of that patient.
Dr. Berginis a general orthopedist, surgically and conservatively treating all manner of bone and joint conditions. She enjoys educating patients so they can emerge stronger than they were before their orthopedic injury or surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.;;
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What To Expect After Knee Replacement Surgery
When the surgery is over, you will need to stay in the hospitals recovery room for observation. Usually, patients can return to their hospital rooms within a few hours after their pulse, blood pressure, and breathing are stable. Since knee replacement is major surgery, its common for the patient to be in the hospital for a few days before returning home. You will begin physical therapy during this in-hospital time.
When its time to head home, your medical team will have a transition plan to help with continued physical therapy and pain management. Its crucial that you are diligent about following these recommendations to regain the range of motion and strength needed in the joint.
Mayo Clinic Q And A: Pain After Knee Replacement Surgery
DEAR MAYO CLINIC: It has been months since I had knee replacement surgery, but my knee is still hurting. Can anything be done at this point, or does the surgery just not eliminate pain in some patients?
ANSWER: Although its uncommon, a small percentage of patients continue to have chronic knee pain after knee replacement surgery. But when that happens, you dont have to just put up with the pain. Have your situation evaluated. Several additional treatment options may ease chronic knee pain after knee replacement.
Knee replacement surgery, also known as knee arthroplasty, is one of the most common orthopedic surgeries performed today. It is most often used to repair joint damage caused by osteoarthritis or rheumatoid arthritis that causes severe knee pain and makes it hard to perform daily activities.
During knee replacement, a surgeoncuts away the damaged bone and cartilage from your thighbone, shinbone andkneecap, and replaces it with an artificial joint. For most people, kneereplacement significantly improves mobility and relieves knee pain. But in somepatients, the pain persists after surgery.
Your first step in dealing withongoing knee pain in this situation is to make an appointment to see thesurgeon who performed your knee replacement. He or she can evaluate your kneeand check for possible complications from the surgery, such as an infection ora problem with the artificial joint.
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How Long Swelling Lasts
I can not answer this question because there is no right answer to this.;
From my experience as a PT with keenness on Knee replacement rehab, I can say that I have seen patients complaining about swelling problems for 3-6 months on average.;
However, there were some patients too, who had a swelling present for one or two years after knee replacement.
What Can Cause Knee Pain Years After A Knee Replacement
Knee replacements dont last forever. Most knee replacements perform well and cause no issues to patients for 10 to 20 years after the operation. When pain occurs years after knee replacement, its typically due to one of these four knee replacement problems after 10 years or more.
- Soft tissue irritation around the knee The most common pain patients experience that occurs years after a knee replacement will be the soft tissue around the knee.; Patients still have multiple tendons, ligaments, and muscles around the knee that may become irritated with varying activities.
- The implant becomes loose; A loosening implant is a cause of pain that can occur years after knee replacement surgery. A loosening implant is typically caused by wear and tear over time, though it can be exacerbated by high-impact sports or obesity. A loosening implant can cause pain as well as instability in the knee and a change in the alignment of the knee joint.
- Infection; The infection rate after knee surgery is very low, around 1 percent. If an infection does set in around the components of the knee replacement, it can be difficult to treat with antibiotics. Revision surgery may be necessary to get the infection under control.
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How Long Will My Hip Or Knee Replacement Last
Senior Faculty Editor, Harvard Health Publishing
For people considering hip or knee replacement surgery, its something they want and need to know.
In the US alone, surgeons perform more than 600,000 knee replacements and about 330,000 hip replacements each year. These operations can provide a and function for those with severe arthritis. On the other hand, there are risks associated with the operation , there is a long road to recovery even when all goes well, and these operations arent cheap. For knee replacement surgery alone, an estimated $9 billion or more is spent each year in the US .
So, if the first joint replacement is unsuccessful for some reason , a second operation may be necessary. And thats a big deal, especially since “revision surgery” is technically more difficult, recovery can take longer, and success rates may be lower than first operations.
What Are The Odds Of Chronic Stiffness After Knee Replacement
As many as;4% to 35%;of patients can develop chronic knee stiffness after ACL surgery. Known as knee arthrofibrosis, it’s one of the most serious side-effects of knee surgery.
Arthrofibrosis, or stiff knee syndrome, occurs due to excessive scar tissue build-up. If this happens, the knee joint can shrink, tighten, and become stiff and painful. In more severe cases, this condition can have a massive impact on;a knee’s range of motion.
Arthrofibrosis can also cause the following symptoms aside from chronic knee stiffness.
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How Long Will I Need Pain Medication After Total Knee Replacement
Pain, swelling, and bruising are all normal after knee replacement surgery, both for partial and total knee replacements. Youll be sent home with oral pain medications after your surgery, which youll take for several weeks after your surgery.
The most commonly prescribed pain medications after knee replacement surgery include prescription-strength naproxen sodium, ibuprofen, and acetaminophen. If those commonly used pain relievers dont provide enough relief, your doctor can prescribe something stronger, such as hydrocodone or an opioid pain killer. Narcotics are addictive pain relievers and can be taken safely after surgery but the duration of these drugs if chosen for use, should be limited as much as possible. Please speak with your physician prior to surgery in regards to the pain protocols that will be used postoperatively