PAIN   IN  THE  TOTAL KNEE


Patients do have occasional pain after total knee replacement  even if their total knees are healed flawlessly.

( see the chapter: Life with total knee)


How frequent is the knee pain after total knee replacement?

Several studies show that between 5 -20% of all patients   still have had moderate to severe pain in the total knee several years after the surgery. Only a minority of these patients, however, were eventually operated on anew.


 

Where do the patients perceive the pain?

Pain in and around the patella (kneecap) is very frequent. According to many studies, patients with resurfaced patella have almost equally often kneecap pain as patients without resurfaced patella.

Diffuse knee pain is often observed in total knee infection or loosening.

Pain in the lower thigh or beneath the knee is observed in loose total knee prostheses with long stems, reaching into the thigh- (femur) or shinbone (tibia).

Pain in the total knee associated with effusion in the joint occurs in worn out polyethylene components.

Pain radiating from outside the knee área to lower leg and foot (big toe) occurs in compression of peroneal nerve.

Pain  from the  hip and lumbar spine disease may also irradiate into  in the total knee joint area.


Individual causes of pain

 

Pain in the non resurfaced kneecap

The not  resurfaced kneecap may cause anterior knee pain ( pain in the front of the knee). After the additional operation -resurfacing of the patella, however, the pain may continue. Also the resurfaced kneecap may cause   pain in the front of the knee.  

Pain from impingement of the kneecap in the unicompartmental knee prostheses

Worn out polyethylene liner in the patellar prosthesis

Badly balanced kneecap that dislocates and subluxates

Painful clunk in the kneecap

Pain from the extensor (quadriceps) tendon if the surgeon moved the attachment of the tendon on the tibial tubercle (a prominence in front of shinbone) .

For more information visit also the chapter  Other complications of total knee surgery


Patellar clunk syndrome

Is a painful clunk that appears when the patient flexes the total knee joint  to 45 degrees. The clunk is caused by fibrous nodule that formed in the joint capsule.

See more in the chapter Other complications of total knee surgery


 

Loosening of the total knee

causes diffuse pain in the knee associated with walking and other activity. Usually the pain develops slowly years after the total knee surgery. Laboratory tests are normal.  

For more information visit also the chapter Loosening of the total knee.


Total knee infection: 

causes diffuse pain, often associated with effusion in the knee joint, in some patients even with sinuses. Sinus is a small opening in the operation wound that secrets pus-like liquid. Laboratory tests show elevated values of ESR and CRP.

For more information visit also the chapter Infection of the the total knee.


Before you take any action please read the DISCLAIMER


BACK to Total knee Index

NEXT to General complications