Painful Knee Replacement

Evaluating a painful knee replacement is essential to identify the underlying cause of the pain and determine the appropriate course of action. Pain following a knee replacement, also known as a total knee arthroplasty (TKA), can be caused by various factors. Some indications to evaluate a painful knee replacement include:

1. Persistent or New-Onset Pain: If a patient experiences persistent or new-onset pain in the knee joint or surrounding areas after a knee replacement, it should be evaluated. This includes pain in the thigh or lower leg as well as the knee itself. Pain that does not improve with time or conservative measures warrants further investigation.
2. Change in Pain Character: A change in the character of pain, such as increased intensity, sharpness, or throbbing, may indicate a problem. Pain that becomes more severe over time or with activity should be evaluated.
3. Limited Range of Motion: If there is a significant decrease in the range of motion of the knee joint compared to what was achieved initially after surgery, it may indicate a problem with the implant, soft tissues, or other structures.
4. Swelling or Inflammation: Swelling or inflammation around the knee joint can be indicative of an issue. It may suggest an infection, an adverse reaction to the implant (e.g., metal hypersensitivity), or other complications.
5. Fever or Signs of Infection: Systemic symptoms like fever, chills, or signs of local infection (redness, warmth, drainage) should raise suspicion of a possible infection around the knee replacement.
6. Instability or Dislocation: If the knee joint becomes unstable or if the patella, also known as the knee cap, experiences recurrent dislocations, it should be evaluated. Instability can be due to problems with implant positioning, ligamentous laxity, or other factors.
7. Radiographic Changes: Abnormal findings on X-rays or other imaging studies, such as loosening of the implant components, wear and tear, or malalignment, may necessitate further evaluation.
8. Functional Decline: A noticeable decline in the patient’s ability to perform daily activities, walk, or bear weight on the operated knee may signal a problem.
9. Continued Pain Beyond the Expected Healing Period: While it is normal to experience some discomfort in the weeks or months following knee replacement surgery, pain that persists beyond what is considered the expected healing period (typically several months) should be evaluated.
10. Implant-Related Recalls: If there has been a recall or safety concern associated with the type of implant used in the knee replacement, it may be necessary to evaluate the patient for any related issues or complications.

Evaluation of a painful knee replacement typically involves a combination of clinical assessment, imaging studies (X-rays, CT scans, MRIs), blood tests, and sometimes joint aspiration to check for infection. The specific treatment or intervention will depend on the cause of the pain, which may include revision surgery (replacing or repairing the implant), infection management, physical therapy, or other approaches.

Patients experiencing pain or other concerning symptoms following a knee replacement should promptly consult their orthopedic surgeon or healthcare provider for a thorough evaluation and appropriate management. Early intervention can lead to better outcomes and improved quality of life. At Total Orthopedics and Sports Medicine we have experts who can evaluate your painful knee and help to determine the correct course of action.