So What Should You Do If You Have Painful Joints After Tka
Suffering from joint pain can be debilitating to your lifestyle and overall happiness. Seek medical advice if you are suffering from pain knee pain after a TKA procedure. There are many solutions to treating the cause of your pain or managing your pain symptoms. If you are experiencing knee pain after a TKA, talk to your doctor as soon as possible.
Personalized Orthopedics of the Palm Beaches has a wealth of knowledge and experience on joint pains and TKA procedures. If you are suffering from knee pain after a TKA, call 561-733-5888 today to make an appointment with one of our experts.
Interference With Daily Activities And Sleep
Before proceeding with hip replacement, your hip arthritis should markedly impact your daily living. Patients who are unable to climb stairs and put on shoes or who need a cane should begin to think about hip replacement. Also, when patients must change their activities or avoid social outings because of hip pain, it may be time to consider this procedure.
Patients who have hip pain that, at the end of the day, keeps them from sleeping despite the use of pain-relief medications should consider hip replacement.
In This Section:
Problem: Fixing Pain After Total Knee Replacement May Include Amputation
Three in 1000 patients will need to have their leg amputated.
The causes of the amputation were:
- infection around the implant ,
- soft-tissue deficiency surrounding the implant ,
- severe bone loss ,
- fracture around the implant ,
- circulatory damage .
In 80% of the cases, there were more than 2 of these factors for amputation.
In research from April 2017, doctors writing in the European Journal of Orthopaedic Surgery and Traumatology wrote:
Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life, and even amputation of the limb.
The purpose of this study was to identify risk factors for amputation in the periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis. We included 183 patients with periprosthetic knee infection 23 required amputation as definitive management .
They found that patients with:
- Increased surgical time > 120 min,
- diabetes mellitus had an increased risk of amputation.
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Common Characteristics Of Hip Joint Stiffness
Hip joint stiffness can commonly be described by the following details.
- Difficulty with movement: You may have trouble forcing the hip joints to flex or move, especially after sitting or lying down for a while.
- Varying pain levels: Pain may range from mild to severe, and may be felt in the groin and thigh as well as the hip.
- Inflammation: Heat and swelling in the hip joint may occur.
- Spreading symptoms: Other joints, especially the neck and back, may also be affected.
- Pain with exercise: This pain may be severe enough to interfere with walking. However, it may worsen after resting and improve with mild exercise. Although, heavy exercise usually causes pain as well.
What Are The Risks Of Surgery
There are possible risks and complications that may happen through hip replacement surgery associated with anesthesia, including respiratory or cardiac malfunction. Other complications include:
- Blood clots
- Stiffness or instability of the joint
- Need for additional surgeries
Patients at increased risk for complications are those with severe rheumatoid arthritis or systemic lupus. In addition, patients with insulin-dependent diabetes, malnourishment, hemophilia, or those who have had previous prosthetic joint infections are at higher risk. Make sure to contact your orthopaedic surgeon immediately, if you experience any of these problems after surgery.
Joint replacements do not last forever, usually 10-15 years. Hip revision surgery may become necessary when an artificial hip becomes painful. Learn more information on hip revision surgery.
Several variables affect the ultimate success of hip replacement surgery. These include the strength of the patients bones and muscles and his or her general health and lifestyle. Commitment to a rehabilitation program is also an important part of the recovery process, since improvement to the hip joint is determined by the patients rehabilitation effort.
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A Loose Implant In The Hip Joint
The next most likely cause of thigh pain after hip replacement is a loose implant from the surgery.
This was a more common issue in the past, when the medical field wasnt quite as advanced as it is now. These days, surgeons, implants, and the tools they use to install them have come a long way.
But, it is not unheard of. Unlike an infection in your new hip, a loose implant is more likely as time goes on and you put some wear and tear on your new hip.
As the hip loosens, it rubs on the bone and ligaments surrounding it. This is what causes the pain in your thigh.
You can visit your doctor and tell them about your condition, and they can help identify if the implant is loose. Its a pretty easy fix if this is whats plaguing you.
This can be very frustrating, and leaves you asking, how long will this thigh pain last?
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Research: Surgeons Warn Surgeons That Knee Pain After Knee Replacement Does Not Automatically Mean Revision Knee Surgery
One of the reasons that people are in our office with continued pain after knee replacement is that they are being told that eventually, or sooner, rather than later if the pain persists, they will have to have revision surgery to clean out tissue that may be causing pain, and to examine the components of the artificial knee.
A recent study from orthopedic surgeons in Italy was published in the Current Reviews in Musculoskeletal Medicine. Simply stated the surgeons warned:
Pain can be related to a lot of different clinical findings, and the surgeon has to be aware of the various etiologies that can lead to failure. Pain does not always mean revision, and the patient has to be fully evaluated to have a correct diagnosis if surgery is performed for the wrong reason, this will surely lead to a failure.
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Pain Control After Joint Replacement
Joint replacement surgery, such as knee and hip replacement, is often done to reduce the pain caused by arthritis. However, in the days following surgery, some patients pain is just as bad or even worse than their original arthritic pain. While we understand that surgery without any pain is the exception and not the rule, we take pain very seriously and take a multidisciplinary approach to limiting pain to maximize recovery.
Research: 10% To 34% Of Patients Are Not Satisfied With Knee Replacement
In August 2017, doctors at the University Hospital Leipzig in Germany opened their published research in the medical journal Patient Safety in Surgery with this statement:
- In spite of the improvement of many aspects around Total knee arthroplasty , there is still a group of 10% to 34% of patients who are not satisfied with the outcome.
- The therapy of chronic pain after total knee replacement remains a medical challenge that requires an interdisciplinary therapy concept. .
What this paper deals with is an ever-growing population of people for whom knee replacement did not work.
In their paper the Leipzig researchers were looking at effective means to help the patient with pain after knee replacement, a brief summary of their findings is presented here:
The treatment of patients with chronic complaints after total knee replacement is a challenging task. Therefore, an adequate therapy is only possible due to an interdisciplinary team of experienced orthopaedic surgeons with great knowledge in the field of endoprosthetic , qualified physiotherapists and pain therapists.
The researchers then assessed the following of having some benefits:
- Acupuncture or Traditional Chinese Medicine which assisted in reducing knee swelling in some patients
- Gentile Physiotherapy .
- Injections of bupivacaine and lidocaine for very temporary relief
- Treatment should be supported by psychotherapists or psychologists with experiences in the area of psychosomatic medicine.
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Lateral Femoral Cutaneous Nerve
During the anterior approach to a hip replacement, the lateral femoral cutaneous nerve travels near the incision. The nerve can be stretched or cut during surgery. Injury to the nerve can cause numbness to the thigh region. Sometimes the damage can create a neuroma, which can become painful.
Some surgeons routinely cut the nerve during an extensive surgical approach to the hip. Dr. Morton is a fellowship-trained hip specialist and is careful to minimize this risk as much as possible by performing a minimally invasive procedure.
Suppose you are having pain or numbness to your anterior thigh. In that case, a physical examination will help determine if this is the cause.
Pain After Hip Replacement: Causes And Tips To Help
It is natural to think that you will have no pain after your hip replacement surgery, but things may not work that smooth for some people. Pain after hip replacement is more common than you think. In fact, sometimes, the pain you experience is even worse than what you were experiencing before undergoing the surgery. A number of factors may be preventing you from getting the best results after your surgery.
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Infection In The New Hip
One of the potential causes of thigh pain immediately after hip replacement is an infection in the new hip.
Even with the antibiotics you take, its possible to end up with an infection if you arent very careful with the recovery process. Keeping your wound clean is the best way to prevent this issue from arising in the first place.
Most often, you can remedy this problem by making an appointment with your doctor and getting on some antibiotics. Other times, an infection in your artificial hip will require surgery to remove the hip. So needless to say, this is something you want to try and prevent at all costs!
But, sometimes, you may still experience thigh pain years after your hip replacement.
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Why Am I Still Experiencing Pain
Nearly 200,000 people in the U.S. undergo hip replacement surgery every year, making it one of the safest surgeries to perform. In fact, the success rate is incredibly high with only 2% of patients reporting surgical complications like joint infection.
However, if you are still experiencing significant pain after surgery, you should contact your surgeon as soon as possible to find out what is causing the pain to persist. This will ensure that treatment is given in a timely manner to prevent further damage. If pain persists beyond what is considered to be normal, it could be due to one of several risk factors.
Hip replacement surgery pain causes may include:
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Brief Background Of My Tkr
For decades I walked with a limp on a bowed leg. This was before my knee replacement surgery.
Over the years my walking mechanics deteriorated. I favored my right leg and put extra stress on my left leg because I relied on it more.
During my knee replacement surgery, my surgeon said he was able to take the bow out of my knee. He actually realigned my leg!
I didnt believe him until I saw the result. I was amazed and my knee felt more stable with the knee replacement !
When your knee is realigned, the balance of your body will naturally need to adjust. Early on, youll need to relearn how to walk correctly.
My therapist made me concentrate on using proper walking mechanics from day one of my therapy. I was encouraged not to lean to one side of my body when I walked and I focused on walking forward heel to toe.
My therapist gave me hip exercises along with my knee exercises. In hindsight, it seems she knew that many patients experience hip pain after knee replacement .
She emphasized that I should focus on strengthening the muscles around my knee and in other parts of my leg. Strong muscles would better protect the joints in my knees and hips.
What Restrictions Will I Have After Surgery
Depending on how your surgeon performs your surgery, you may have slight differences in your rehabilitation instructions including restrictions. In general most surgeons prefer that you avoid certain positions of the hip that can increase your risk of dislocation of the hip for about six weeks following surgery. After six weeks, the soft tissues involved in the surgery have healed, and restrictions are often lifted allowing more vigorous activity.
Many surgeons suggest that you avoid any repetitive impact activities that can increase the wear on the implant such as long distance running, basketball, or mogul skiing. Otherwise limitations following hip replacement surgery are few however, the better you treat your replacement the longer it will last.
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Preparing For Knee Replacement Surgery
Before you go into hospital, find out as much as you can about what’s involved in your operation. Your hospital should provide written information or videos.
Stay as active as you can. Strengthening the muscles around your knee will aid your recovery. If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation. You can be referred to a physiotherapist, who will give you helpful exercises.
Read about preparing for surgery, including information on travel arrangements, what to bring with you and attending a pre-operative assessment.
What Happens After Hip Replacement Surgery
You will likely stay in the hospital for four to six days and may have to stay in bed with a wedge-shaped cushion between your legs to keep the new hip joint in place. A drainage tube will likely be placed in your bladder to help you go to the bathroom. Physical therapy usually begins the day after surgery and within days you can walk with a walker, crutches, or a cane. You will continue physical therapy for weeks to months following the surgery.
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What Happens After Surgery
After surgery, medicines or physical therapy may be prescribed by your surgeon to prevent blood clots. To decrease your chances of having a Deep Vein Thrombosis after surgery, you may be given medication, wear special stockings and do ankle pumps two to three days following surgery. You also may be given patient-controlled analgesia which allows you to control your own pain medication through an IV and lasts for 1 or 2 days after surgery. You may have an appointment after surgery depending on the wound closure method preferred by your surgeon to have the sutures removed. You should call your surgeon before this appointment if you experience any of the following symptoms:
- Increased redness
- Any other changes you question
Lack Of Evidence About The Effectiveness Of Prediction And Management Strategies For Chronic Postsurgical Pain After Total Knee Replacement
The same doctors also wrote in the British Medical Journal that the problem of post-surgical pain in knee replacement patients had reached a point of significance and that researchers should prioritize their studies to help people with pain. They wrote:
- Our highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. We are going to return to this study below.
There is a significant problem. The main part of this problem is identifying what is causing people to have pain after knee replacement.
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When Can I Shower
Most surgeons do not like the wound to be exposed to water for five to seven days however, more surgeons are using waterproof dressings that allow patients to shower the day after surgery. You can remove the dressing at seven to ten days after surgery. Once you remove the dressings, you still shouldnt soak the wound until the incision is completely healed three to four weeks later. Either way, it is important to discuss this with your surgeon to be assured when it is safe to shower and what wound closure technique/dressings will be used for your surgical wound.
What Causes Thigh Pain After Hip Replacement
There are two different categories of post-surgery pain we want to discuss. One is completely normal, while the other may indicate some sort of issue.
It should come as no surprise that you experience some pain in the replaced hip and surgery area after you go under the knife. The process of undergoing hip replacement is very taxing on the boney formations in that area, along with all the muscles, ligaments, and even your skin where incisions were made. Lets cover some of the specific potential causes of pain after surgery.
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Patients May Still Be Undergoing Knee Replacement For Degenerative Lumbar Spine And Hip Osteoarthritis
Patients may still be undergoing knee arthroplasty for degenerative lumbar spine and hip osteoarthritis. . . We suggest heightened awareness at pre-and post-operative assessment and thorough history and examination with the use of diagnostic injections to identify the cause of pain if there is doubt.
In other words, patients received a knee replacement when the cause of pain came from the hip and spine.
In the journal Modern Rheumatology, Japanese doctors wrote:
We suggest that rheumatologists be aware of hip disease masquerading as knee pain or low back pain.
In the case of chronic joint pain, a thorough examination is imperative in identifying the correct diagnosis. That sounds like common sense, but the sad truth is that the source of pain is often missed because of misinterpretation of MRI and other imaging scans. Please see our article on MRI accuracy.