Experiencing pain after a total knee replacement (TKR) surgery is not uncommon. While the procedure is generally successful in relieving knee pain and improving mobility, some patients may still experience discomfort post-surgery. There are several factors that can contribute to this pain.
At 6 mo post-operatively, pain at movements was found in 16% of patients[21] while pain at rest was significantly reduced in 5% of the patients.[21]. PPSP has been reported at 1 year post-operatively in 13.1% of the patients[19] while in another study, 44% of the patients reported to had PPSP at a mean of 4 years after TKR[9]. Balancing your recovery with your work life can be incredibly difficult without proper planning. If possible, arrange for flexible work hours or a temporary reduction in workload to accommodate your rehab needs.
1. Inflammation
One of the main causes of pain after TKR knee surgery is inflammation. The body’s natural response to surgery is to send blood flow to the area to promote healing. This can result in swelling, which puts pressure on the surrounding tissues and nerves, causing pain.
2. Scar Tissue Formation
Another common cause of pain after TKR knee surgery is the formation of scar tissue. As the body heals, scar tissue can develop around the incision site or within the joint itself. This can restrict movement and cause discomfort when bending or extending the knee.
3. Muscle Weakness
Differences in QALYs during the first year for the same health state between the different pathways reflect the findings of the trial for the two arms separately. From this review, it is obvious that post-surgical pain and NP exists in a significant proportion of patients, for years after TKR. Risk factors that might affect its prevalence and its intensity, found to be emotional functioning, such as depression and pain catastrophizing, number of comorbidities and early grade of osteoarthritis. Nevertheless, due to the heterogeneity of the studies, mainly on the scales used to assess pain and preoperative factors, we are unable to reach firm conclusions concerning the prevalence, and the risk factors of persistent post-operative pain after TKR.
Although it became recognizable the existence and the prevalence of PPSP and NP after TKR, these studies did not lead us to firm conclusions. Thus, further studies concerning the prevalence of PPSP and NP and their risk factors are needed, with pain-specific instruments. Only 14 studies that match the inclusion criteria and measured pain with pain specific instruments were selected for this review. Following a post-operative plan after knee surgery is crucial to your recovery. Consult with Orthopedic Surgeon, Ira Guttentag, MD for diagnosis and treatment options after a knee injury.
FNB was widely used to control postoperative pain and opioid consumption after TKA,3,5 although it only covers pain from the antero-medial part of the knee, leaving the posterior knee uncovered. A total of eight RCTs compared ACB with LIA54,169–175 (six of them included in a recent meta-analysis142). The majority of the RCTs used multimodal analgesia with paracetamol, COX-2-specific inhibitor, gabapentinoid and systemic opioid. There was a significant variability in the LIA volume (40 and 100 ml, five of eight RCTs) or solution (three of eight RCTs). Previously, the researchers demonstrated that injecting the antibiotic vancomycin directly into the tibia before surgery helped in reducing infection by reaching a higher concentration of the drug in the knee. Motivated by this success, they investigated whether adding morphine into the tibial bone with a standard antibiotic solution could improve postoperative pain management.
Muscle weakness in the quadriceps and other surrounding muscles can also contribute to pain after TKR knee surgery. Weak muscles can put additional strain on the knee joint, leading to discomfort during movement.
A knee replacement might improve your mobility in the long term, but you’ll probably be less mobile as you start to heal. A reasonable timeframe for a full recovery from a knee replacement is about one year, but you may be able to move around on your own within four to six weeks. Post-surgery care may also include the use of compression therapy to reduce swelling and improve circulation throughout the body. If necessary, your doctor will recommend the use of assistive devices like walkers or crutches to help you maintain your balance. Changes in biomechanics after knee surgery may also lead to hip pain on the same or opposite side of the knee joint replacement. It is important to note that knee joint infection is rare and occurs in less than 2% of knee replacements.
As PoPC was applied to generate corresponding values for CP and NCP for all following cycles (years 2 to 5), QALY estimates for the CP and NCP health states were the same across the comparators. Transition probabilities remained the same as the base case, i.e. they differed between arms, hence each strategy could accrue a different total number of QALYs based solely on how simulated patients transitioned through the CP and NCP health states. These results were then compared to the base case to assess how the assumption impacted the model.
4. Nerve Damage
In some cases, nerve damage during surgery can result in persistent pain post-operatively. This can manifest as shooting or burning sensations in the knee, or even numbness in the surrounding areas.
5. Infection
Although rare, infection can occur following TKR knee surgery and lead to pain, swelling, redness, and warmth in the affected knee. If left untreated, an infection can cause serious complications and should be addressed by a healthcare professional immediately.
Managing Pain After TKR Knee Surgery
If you are experiencing pain after TKR knee surgery, it is important to communicate with your healthcare provider. They may recommend physical therapy, medications, or other interventions to help alleviate your discomfort and improve your recovery process. It is crucial to follow their guidance and stay diligent with your rehabilitation exercises to ensure the best outcomes.
