Knee Replacement Complications In Former Athletes
In a recent paper, doctors from NYU Langone Medical Center, Hospital for Joint Diseases suggest that total knee arthroplasty is often the best answer for end-stage, post-traumatic osteoarthritis after intra-articular and periarticular osteoarthritic fractures the knee.
However, total knee replacement in the setting of post-traumatic osteoarthritis is often considered more technically demanding surgery and the surgical outcomes are typically worse for these patients. The goal of the NYU paper was to create a new classification label for post-traumatic osteoarthritis patients and improve medical documentation and improve patient care.
- The researchers looked at post-traumatic osteoarthritis patients who suffered from osteoarthritis as a result of high demand or athletic activity. These were on average were younger and healthier than the primary total knee replacement population .
- The healthier post-traumatic total knee replacement group had the following complications:
- higher rates of superficial surgical site infections,
- bleeding requiring transfusion,
- increased length of hospital stay,
- and 30-day hospital readmission.
In a similar study, doctors at Duke University also recognized that Total Knee Arthroplasty as an important treatment for post-traumatic arthritis. However, these researchers also found complications that should not be expected in a mostly healthy patient population.
- knee wound complications
- need for revision surgery.
Catastrophizing Thoughts And Central Sensitization = Catastrophic Results And Opioid Dependence After Knee Replacement
Researchers in Canada writing in the Journal of Pain Research found pain catastrophizing reflects a patients anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain, and a sense of helplessness regarding pain.
Catastrophizing thoughts are unrealistic beliefs that only the worst can happen. A person who goes into any medical treatments believing it will not work is at a significant disadvantage. A patient should relay these thoughts to his/her doctor so that appropriate action can be taken. For some patients, counseling will be effective, for some therapy, for some prayer. The patients must be made aware of options that will help them move from hopelessness to cautious optimism.
A significant problem with catastrophizing thoughts that needs to be addressed is a greater risk for opioid dependence.
Doctors in Belgium write in the Bone and Joint Journal that pre-operative pain in the knee predisposes to central sensitization . Pain due to osteoarthritis of the knee may also trigger neuropathic pain and may be associated with chronic medication like opioids, leading to a state of nociceptive sensitization called opioid-induced hyperalgesiapainkillers increase chronic pain.
Cindys Story: No More Stabbing Pain After Knee Surgery
Wednesday, July 28, 2021
Cindy Jasper tried just about everything to ease her chronic, arthritic knee pain cortisone injections, topical gels, you name it. None of it brought her the long-lasting relief she desperately sought.
Adding to her woes: Both her knees were arthritic and virtually bone on bone, the cushioning cartilage having worn out long ago. The result was constant, excruciating pain.
I couldnt even put pressure down on my leg, says Jasper, who is in her 60s. I had two Bakers cysts on the back of my leg. One was the size of a golf ball and one was just a little bit smaller.
A Baker’s cyst is a fluid-filled cyst that develops at the back of the knee. Its often the result of a problem within the knee joint such as osteoarthritis.
The pain is like a stabbing, someone taking a knife and just stabbing it in your knee and twisting it, Jasper says. You cant straighten your leg out. its just that type of pain that just hurts a lot.
Jasper turned to Dr. Carl A. DiRaimondo, an orthopedic surgeon with Orthopedics & Sports Medicine BayCare Clinic in Manitowoc, in search of treatment that would provide long-term relief from her knee pain. Double knee replacement surgery was the solution.
A typical knee joint has a layer of cartilage that breaks down over time, causing osteoarthritis. That, in turn, results in less joint space, resulting in pain, swelling and dysfunction.
The surgery was a success.
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Additional Studies On Knee Pain After Knee Replacement
While this most recent study we highlighted shows nearly 40% of patients still having chronic knee pain after knee replacement, there are other studies reporting higher percentages.
This French study looked at almost 2,000 knee replacement patients one year after their surgery . They used a nationalized health care system to track the new use of over-the-counter pain medicine, nerve-pain drugs, and narcotics.
While we would expect to see very little new use of pain medications in this group of patients, a very surprising 47% of patients began taking new analgesic medications during the year after their surgery! About 9% needed new nerve drugs and about 6% new narcotic drugs. Younger knee replacement patients and those with more pain before the surgery needed more drugs.
This study looked at more than 1,700 patients who had knee replacement . The focus was to determine how many would still have pain coming from the front of the knee joint. The researchers found that at five-plus years later, 20% had pain in the front of the knee.
However, a stunning 54% of patients still had knee pain with only 46% being pain free. Also interesting was that 87% of patients had their knee pain develop after the surgery and within the first five years. In addition, knee pain in the front was more common among younger and more active patients.
This study reported 44% of patients with chronic knee pain after knee replacement and a remarkable 15% with severe-extreme persistent pain .
How To Relieve Sharp Stabbing Pain On The Inside Or Outside Of The Knee
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Should I Use Muscle Relaxers After Knee Surgery
Many surgeons use muscle relaxants on patients who undergo surgeries. They do so to restrict muscle movement while patients are unconscious. However, researchers now associate them with increased risks of lung complications.
As such, you may want to avoid over-the-counter muscle relaxants after your surgery. You should only use them if your doctor prescribes them.
Shin Pain After Knee Replacemen
Adhesion in the Knee Capsule is One of Most Common Causes of Pain On Inside of Knee. When it comes to pain on the inside of your knee, they’d look for adhesion inside of your knee capsule. The knee capsule is a paper-like sheath that surrounds the whole knee joint For those worried that a knee pain diagnosis will inevitably lead to knee replacement surgery, take heart: Many knee problems respond well to noninvasive treatments that allow you to either avoid surgery or at least delay it. Causes. If you are over 50 and have knee pain, it is likely due to one of the following issues: Osteoarthriti In general, knee pain is widespread and will usually disappear after the activity is over and a little treatment. However, stabbing knee pain at night can be experienced by elderly patients. Though middle age people also tend to have the same risk factors considering the specific condition such as arthritis
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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.
What Causes Pain After Knee Replacement Surgery
The most common causes of pain after knee replacement include: Loosening of the implant: This is most often the cause of pain years or decades after the knee replacement however, it is seldom the cause of persistent pain right after surgery. 3. Infection: Infection is a serious and worrisome concern.
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Stabbing Pain After Tkr
Hi guys, well what a difference a few days makes. Im just over 3 weeks post-op and posted a few days ago how good i was feeling, well things have changed a lot since then. Everything was fine i was doing my exercises and walking without much pain but these last two days things have changed dramatically. I can do my exercises without experiencing any more pain than normal but my walking ability has dramatically changed. After a couple of minutes of walking i am getting a stabbing pain in the inner part of my kneecap and its really starting to worry me. I would love to hear your opinions on this i know its early days but i didnt have this pain before which is why im worried. The doctor stopped my ibuprofen a few days ago and i wonder if this could have anything to do with it.
Posted 4 years ago
Expect anything for the next few weeks Lisa, odd feelings, pains, aches, swelling. It’s early days, everything will knit together and gradually get better.
If you have pain take ibuprofen, if not don’t. It’s so unpredictable at the stage you are at.
Posted 4 years ago
Its true you worry about every ache and pain and it came on so quickly it worried me but im going back on tbe ibuprofen and see how it goes.
Thanks this forum is so good for support.
Posted 4 years ago
Its good to hear that im probably expecting too much too soon just hope it subsides. I will just have to give it time.
Thanks for the support
An Unusual Cause Of Lateral Knee Pain Following Total Knee
It has been over a month now and I am still recovering. My knee never lost all the swelling and pain increases with even mild activity sitting with knee bent 90 degrees and driving are everyday challenges. I am now going through physical therapy and pray this works. I have been told several things such as cortisone flare, bursitis, broken blood vessels or. The knee pain is absolutely ridiculous. I never ever would have gone through a total knee replacement if I had known how painful this would be 2 years later. I am now in a wheelchair and can’t walk at all because of it. No one knows what’s wrong. I walked into surgery but I never walked again after total knee replacement From the perspective of Chinese medicine, it is the stomach meridian which starts underneath the eye, goes through the stomach, passes through the knees and down to the toes. The same meridian can affect several places along the pathway. Often, fo.. This tendon can cause fibular head pain when there are problems with the muscle and the tendon gets too much wear and tear. That can happen due to imbalances in the body or even if there are irritated nerves in the low back that impact the muscle and tendon. The lateral collateral ligament is on the side of the knee and stabilizes the.
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When Will My Kneecap Start To Feel Better
One broad caveat to keep in the back of your mind. Many of you are thinking that a few weeks are enough time to start to see improvements with treatments such as exercise or physical therapy. Sadly thats not going to happen. It is not unusual for it to take 3-4 months before you start to see significant improvement in your pain. Furthermore, it is not uncommon for it to take 8-12 months for a complete resolution of your symptoms. This is important I wouldnt want to seek a surgeons consultation because 4-6 weeks of therapy and exercise left you with persistent pain.
Down below.. under coping strategies, we list a few things to try that can calm down your pain while we give the exercise time to work.
Problem: Neuropathic Knee Pain After Surgery Nerve Damage Caused By The Surgery
Above we discussed neuropathy, nerve damage, as occurring in a small portion of knee replacement patients. A study from doctors in the United Kingdom published in the Bone and Joint Journal suggests that while a small percentage of patients suffer from neuropathic pain caused by knee replacement, it is still an underestimated problem in patients with pain after total knee replacement.
- Neuropathic pain peaks at between six weeks and three months postoperatively. Currently, doctors believe the best choice of recommendations for neuropathic knee pain is pharmacologic management. For a discussion on Prolotherapy and nerve damage see our article on Neurofascial Prolotherapy.
The same research team had more to say in a 2017 study that will be discussed below.
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Patellar Tendinitis / Tendinopathy
Patellar tendinitis means inflammation of the tendon below the kneecap. Tendinopathy means an abnormal condition of the tendon in which there is no inflammation. Both of these problems can still hurt, and the pain is usually felt on the front of the knee just below the kneecap.
Flexibility of the quadriceps muscles can play a role in this type of pain, but more often it comes from the muscle overworking because the glute muscles aren’t doing their fair share.
What about those patellar tendon straps? Do they work?
Patellar tendon straps can help take the edge off the pain if you have patellar tendonitis. They relieve stretch on the attachment point of the patellar tendon below the knee, and thus they help temporarily. Unfortunately,they don’t fix the main problem. If the quadriceps muscles are still stiff, the pain will eventually come back. Keep reading to learn how to relieve pain on the front of the knee.
Saphenous Nerve Neuroma After Total Knee Arthroplasty
But after certain activities, the pain may become more intense, coming and going in waves as a sharp, stabbing, or even burning pain. Let’s get into what you came here to learn about today – the most common causing of sharp, stabbing pain in the knee that comes and goes Cause of Knee Pain and Swelling Eight Weeks Out from Replacement Surgery. Dr. Bergin explains, The surgeon has cut the ends of the bones off with a saw, completely dislocated the kneecap, cut out all the cartilages between the two bones, and then spread the filleted soft tissues apart with vigor, in order to expose the knee for the operation.
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Why Does My Knee Pain Come And Go
A sharp stabbing pain in the knee that comes and goes is actually pretty common. This is because many of the potential conditions that result in knee pain flare up.
For example, if you go a few days without much physical activity, the pain in your knee may subside a bit. But then if you exercise, play a sport, or even walk up a flight of stairs you normally wouldnt, the pain will come charging back in full force.
Thats not to say you will feel no pain one day, and wake up the next day in agony. Usually, the pain is always there as a dull, aching sensation. But after certain activities, the pain may become more intense, coming and going in waves as a sharp, stabbing, or even burning pain.
Lets get into what you came here to learn about today the most common causing of sharp, stabbing pain in the knee that comes and goes.
Is Surgery Ever Needed For Anterior Knee Pain
In some cases of patella instability, where the kneecap dislocates often we need to consider surgery to reconstruct the ligament which holds the patella in place.
In cases of severe arthritis of the patella, we occasionally need to consider a joint replacement if you do not respond to a compression sleeve, injections, activity modification, and physical therapy.
Patella tendonitis or a jumpers knee will usually respond to activity modification and physical therapy. It is not unusual for your recovery to take up to 6-8 months. If the pain remains severe, there has been a recent interest in trying PRP injections to regenerate the patella tendon. It is still controversial whether or not PRP injections are useful. Surgery, although rarely needed, can be very useful in severe cases of a jumpers knee.
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