A New Way To Control Pain After Knee Replacement Surgery
In a recent study, Houston Methodist researchers presented clinical evidence supporting the safety and efficacy of injecting pain medication directly into the tibia during knee replacement surgery for better postoperative pain management.
The double-blind, controlled, randomized trial detailed in The Journal of Arthroplasty revealed that patients receiving a mixture of morphine and the antibiotic vancomycin injected into the tibia of their knee joint have less pain post-surgery compared to those who received the infusion without morphine during surgery.
Despite many technological advances, controlling pain after total knee arthroplasty can be challenging most patients experience considerable pain and discomfort, especially in the first couple of weeks into their recovery, said Kwan Kevin Park, M.D., orthopedic surgeon at Houston Methodist. Intraosseous infusion, which involves injecting medication directly into the bone marrow, allows us to control pain pre-emptively so that patients don’t have to take as much pain medicine later on.
Total knee replacement is the recommended treatment to alleviate chronic pain caused by damage to the knee joint from arthritis or injury. According to the 2021 American Joint Replacement Registry Annual Report, primary knee replacement surgeries accounted for 54.5% of the nearly two million hip and knee replacement procedures performed between 2012 and 2020.
Why Is Ibuprofen Not Recommended After Surgery
Because of increased bleeding risk, patients are frequently advised not to take ibuprofen and other nonsteroidal anti-inflammatory drugs before or after surgery.
Why You Should Read The Label On Your Nsaids
If you are prescribed NSAIDs after surgery, you must read the medication label carefully and follow the instructions on the label. Nonsteroidal anti-inflammatory drugs have been shown to be effective in reducing inflammation and pain, but they can also cause serious side effects when taken in excessive amounts or in an overly long period of time.
How The Study Was Performed
The study involved 80 patients undergoing total knee replacement. It concluded that continuous infusion of a local anesthetic 0.2% ropivacaine) through a catheter in the adductor canal of the mid-thighrather than higher up near the femoral nerveprovides better pain control and prevents temporary weakness of the leg muscles. This allows recovering patients to walk sooner with less weakness in the legs, resulting in improved physical therapy participation. Patients in the study also needed less morphine to control post-surgery pain.
Virginia Mason anesthesiologists Neil Hanson, MD, and David Auyong, MD, were members of the research team and co-authors of the article. No one in the world has shown all these possible outcomes in the same study with the adductor canal technique, Dr. Hanson said in a release from the Virginia Mason.
Dr. Auyong added, Use of the adductor canal for pain-block infusion appears to improve safety and clinical outcomes, and reduces the length of time needed for hospitalization. All patients now get this nerve block at Virginia Mason as part of our standard work for knee replacement surgery.
Hanson NA, Allen CJ, Hostetter LS, et al. Continuous Ultrasound-Guided Adductor Canal Block for Total Knee Arthroplasty: A Randomized, Double-Blind Trial. Anesthesia & Analgesia. 2014 118:1370-1377.
Don’t Miss: How Long Off Work For Knee Replacement
Losing Weight To Reduce Pressure On Your Knees
Will losing weight help knee pain? Absolutely. Our knees support us whenever we walk, sit or stand. They take a lot of wear and tear throughout our lives. If youre overweight, losing weight can help make your knees work easier.
Even losing 10% of your body weight can help alleviate knee pain. One pound lost can eliminate four pounds of pressure on your knees.
Excess weight can also add to inflammation throughout your body, which can make the inflammation in your knee more painful. So, losing weight may help reduce that inflammation.
If you have struggled with weight loss in the past, help is available. Dietitians, nutritionists and other specialty doctors can provide medical weight management and guidance to help you reach your goals.
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.
Also Check: How To Fix Jumper’s Knee
Steroid Injections Can Help Knee Pain By Reducing Inflammation
Steroid injections for knee pain are typically corticosteroids shots. Cortisone mimics the effects of a substance called cortisol that is naturally produced by the adrenal glands.
Steroids help reduce the inflammation and offer pain relief, because knee pain is often caused by inflamed tissue.
It usually takes about 3-7 days for steroid injections to work to their full effect. But its possible for a steroid injection to relieve knee pain as quickly as 24 hours.
Though they offer significant pain relief, the effects of steroid injections are temporary. On average, steroid shots relieve pain for three months, though you may feel relief for up to six months.
Steroid injections may also cause side effects. Its common to experience minor pain and swelling in the knees for a couple days after the shot. Your doctor will be able to answer any questions you have about side effects.
How Long Will It Be Before I Feel Normal
You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery. However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear.
Your new knee will continue to recover for up to 2 years after your operation. During this time, scar tissue will heal and muscles can be restored by exercise.
Even after you have recovered, it’s best to avoid extreme movements or sports where there’s a risk of falling, such as skiing or mountain biking. Your doctor or a physiotherapist can advise you.
Read Also: How To Correct Knock Knees
Why Do You Trust Chanrefrigerators
After a long time of researching and learning about: 19 products 9,182 of consumer reports in 2022 and a list of brands that have discussed the topic of renting an ice machine for knee replacement, we have found the advantages and disadvantages of these products with the desire to bring to our customers Important information, the best choices. So you can completely trust our selections and reviews.
Which Nerve Is Most Commonly Injured After Total Knee Arthroplasty
The most commonly injured nerve after total knee arthroplasty is the sciatic nerve. This nerve is located in the back of the leg and is responsible for sensation and muscle movement. It can be injured when the incision is made through the muscle and tissue around the knee joint.
A nerve injury following total knee arthroplasty can cause severe disability. Those who have a history of spinal pathology, as well as women who have a history of this pathology, are at higher risk of nerve damage. It is also possible that tourniquet pressure will be too high or that anesthesia will last longer. In the United States, approximately 1,800 to 6,800 patients suffer from a postoperative nerve injury each year. TKA has few known risk factors for nerve injury. The Medical Research Council defines nerve injury as grade 4/5 or lower motor strength, as determined by the Medical Research Council. We examined sciatic, peroneal, and femoral neuropathies, but we couldnt tell them apart.
Recommended Reading: Why Does My Knee Hurt When I Drive
Alternatives To Knee Replacement Surgery
If you suffer from serious knee pain, it may be recommended to have knee replacement surgery. Since this is a highly invasive surgical procedure, its always best to investigate alternatives before making a final decision. Theres always the risk of infection with any surgery, and a total knee replacement requires a long recovery process. You may even end up with one leg slightly shorter than the other.
Our regenerative treatments will help you avoid knee replacement surgery because they work with your bodys own natural healing process to resolve the underlying cause of your knee pain. Once the cause has been addressed and healed, youll no longer suffer from the pain and discomfort.
Heres a quick look at our regenerative medicine treatments:
Human cellular tissue therapy We source tissue from accredited tissue banks that has been collected from the Whartons Jelly of donated umbilical cords. This tissue contains highly potent healing compounds like cytokines, amino acids, hyaluronic acid, proteins, growth factors, lipids, and collagen.
PRP therapy Platelet-rich plasma is created when we place a sample of your blood in a centrifuge to spin. As the platelets and red blood cells separate, highly concentrated PRP with healing properties is created. We then inject the PRP into your damaged knee tissue to help facilitate the healing process.
May I invite you to join us for a Complimentary Consultation?
Why Does My Lower Back Hurt After Total Knee Replacement
When you first begin walking and moving with a new knee, you may experience some back pain as you learn how to do so. As a result, you will most likely be free of some of your prior back pain over time. As a result of the pain caused by your bad knee, you may have been forced to move in a way that was dangerous to your back.
When your leg length is uneven, it is common for lower back pain to develop. When your legs are not longer than you think, your knees, feet, hips, and low back will be subjected to uneven strain. This causes undue and unequal tension to be applied to the muscles, tendons, and ligaments, resulting in pain. Physical therapists are trained to detect and identify deviations in leg length. If your hip or knee alignment is out of alignment, we will correct that alignment, which will correct the issue and increase your leg length. We can raise the heel or buildup your shoes sole under the short leg in those cases.
You May Like: Latest Knee Replacement Technology 2020
How Long Does It Take For Swelling To Go Down After A Total Knee Replacement
After a total knee replacement, it may take several weeks for the swelling to go down. During this time, it is important to keep the knee elevated as much as possible to help reduce the swelling. Once the swelling has gone down, you will likely be able to start physical therapy to help regain strength and range of motion in the knee.
The total knee replacement is regarded as one of the most effective surgeries in medicine. The most common indication of arthritis in the knee joint is to undergo knee replacement surgery. The prosthetic joints purpose is to replicate the motion and alignment of the natural joint. Swelling can be caused by an excess of fluid in the tissue. If your knee swelling is moderate or severe, it could indicate a serious pathology such as deep vein thrombosis or infection. When fluid is added to the region, blood vessels narrow and fluid flows slower. It is advised that patients raise their leg just above their heart rate.
As the body rises, the fluid from the legs can be diverted more easily to the body. Infection is characterized by swelling caused by inflammation and fluid buildup as a result of bacterial activity. It is necessary to conduct blood and radiological tests as well as revision surgery on the prosthetic joint. Despite the fact that swelling is common after knee replacement surgery, it is critical to consult with your surgeon about any potential complications.
What Should I Expect
Its important to note that everyone has different pain level tolerances, and no two cases are the same because our knees are complex joints. The knees are the second-largest joints in the body, after the hip joints. As such, a knee replacement is a complicated surgery that involves balancing ligaments, cutting into the bones of the knee joint, and replacing parts of the knee joint with artificial parts. The manipulation of the knee joint to place the parts leads to pain after the procedure. Postoperative pain after knee replacement surgery is related to the healing, stretching, bending, and rotating that the knee must do after surgery.
Also Check: Range Of Motion In Knee
Nerve Pain After Surgery: Why It Peaks And What You Can Do
There are a number of reasons why nerve pain may flare after surgery. It is natural for your body to produce less cortisol at night, which is your natural anti-inflammatory hormone. When you remain in the same position for an extended period of time, you will also stiffen up your knee joints. The procedure itself can cause nerve damage as well. It can also result in neuropathic pain, a condition that is frequently overlooked in patients suffering from pain after TKR. There are several types of neurological pain, one of which is characterized by pain that does not directly affect the nerve, but rather by a problem with how the nerves signal travels to the brain. It usually takes between six and three months for the wound to heal after surgery. Its important to note, however, that nerve pain can persist even after surgery is completed. If you have neuropathic pain after surgery, speak with your doctor to see if there are any treatments that may be beneficial.
How To Get A Good Nights Sleep Post
You may have trouble getting a good nights sleep after surgery, but there are a few things you can do to make it easier. It is critical that you obtain adequate rest and that your bed is comfortable. If youre having trouble sleeping, you can try drinking chamomile tea before bed or taking a hot bath before going to bed. If you have difficulty sleeping, it is critical to consult a pain specialist or surgeon. You can consult with them to figure out which solution is best for you.
Don’t Miss: How To Treat Bone Spurs In Your Knee
Strategies To Reduce Pain After Knee Surgery Without Opioids
Hinich and others at U of U Health are working on multiple strategies to reduce opioid pain medication usage.
Creating better tools for measuring pain
Asking patients to quantify pain on the Numerical Rating Scale of 0 to 10 is not scientific, which makes it harder to create effective treatment plans and avoid overprescribing opioids. U of U Health developed a better way to measure pain. Providers discuss pain and how its impacting quality of life with the patient, then input that information into a Clinically Aligned Pain Assessment tool . The tool analyzes the data and offers recommendations for an effective treatment plan.
While developing the tool, researchers studied more than 12,000 pain assessments and found that nurses and patients all preferred CAPA over NRS. The tool accurately identified pain severity and offered effective treatment 81% of the time, compared to just 42% of the time with NRS.
Setting realistic expectations
Recovery after a knee replacement is difficult and long. Pain can last for several weeks, and swelling can continue for up to six months after the operation. But its normal to have some pain. When orthopedic surgeons set that expectation from the start, many patients understand they only need pain medications for a short time, immediately after surgery, when the pain is most intense.
Utilizing physical therapy
How Long Will It Take Me To Recover From Knee Surgery
After knee replacement surgery, you can expect to be able to resume physical activities within six months, but it can take another twelve months for you to fully recover. Despite the fact that a long recovery process can be agonizing, there are some things you can do to speed up the healing process.
Healing After Surgery
It is possible that you will experience stiffness and soreness as your body heals, but with patience and dedication, you will be able to return to your normal daily activities as soon as possible. If you have any questions or concerns about the procedure, consult with your surgeon and physical therapist as soon as possible.
Don’t Miss: Do Knee Compression Sleeves Work
How Much Swelling Is Normal After Knee Replacement
The amount of swelling after a knee replacement is highly individualized. Some people have very little swelling while others may have more. In general, it is normal to have some degree of swelling for the first few weeks or months after surgery. However, if the swelling is severe or persists for a long time, it is important to talk to your doctor.
In the body, an imbalance of chemical components is thought to cause edema. As a result of edema or excessive fluid, an enlarged ortuberculous area can be seen as swelling. My knee is normally swollen and tight in the morning but then becomes swollen and painful at the end of the day. This is a common complaint of the patient. In three tablespoons of fluid within the knee joint, the muscle in the quadriceps can be inhibited at its normal intensity. The bodys movement is inefficient, and as a result, more stress is applied to the tissues, resulting in swelling. To regain strength, you must exercise at a high level both at home and in the gym.