Thursday, June 16, 2022

What Causes Knee Pain After Hip Replacement Surgery

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The Knee Cap Was Floating Because The Mcl Was Released Patellar Maltracking After Total Knee Replacement The Concern Of Catastrophic Laxity

Alleviating HIP PAIN after KNEE REPLACEMENT Surgery. Why and How

Lets look at two studies surrounding the medial collateral ligament.

The first is from 2015, the second is from 2021

In June 2015 in the journal Knee Surgery, Sports Traumatology, Arthroscopy researchers wrote: Medial collateral ligament release is one of the essential steps toward the achievement of ligament balancing during the total knee arthroplasty in patients with varus deformity . When the varus deformity is severe, complete release of the MCL until balanced is often required. However, it is believed that a complete MCL release may lead to catastrophic laxity.

In March 2021, a study published in the journal Knee Surgery and Related Research continued that Medial collateral ligament release during knee replacement could lead to the surviving knee cap floating around the knee. Here are the studys observations: Patellar maltracking after total knee arthroplasty can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. . . Complete release of the MCL during surgery was associated with patellar maltracking. Surgeons should attend to patellar tracking during surgery in medially tight knees.

It Looked Like Neuropathy But It Wasnt Neuropathy Mystery Pain Unclear Pain Difficult To Treat Pain After Knee Replacement Post Knee Replacement Health Problems Are A Bigger Problem Than Anticipated

One of the problems we see in patients who are having problems post-knee replacement surgery is the thinking that knee replacement works for everyone, how come it didnt work for them?

When these patients are presented with research compiled from patient outcomes, they are somewhat surprised to see that they are not so unique after all, many patients have reported problems with expectations and complications of their knee replacement.

Knee replacement is considered one of the great innovations in musculoskeletal care. It is said to be the only known cure for knee osteoarthritis. Orthopedist surgeons routinely tell patients of the great success of the procedure. Yet, it was not until doctors started to perform outcome questionnaire studies that the medical community started to realize what patients had already known knee surgery was not as successful as the surgeons thought.

How Should I Get Into A Car After My Total Hip Replacement

  • The front passenger car seat should be pushed all the way back before you enter the car.
  • Have the driver park on a flat surface and/or near the driveway ramp.
  • Walk toward car using the appropriate walking device.
  • When close to the car, turn and begin backing up to the front passenger car seat. Never step into the car!
  • Placing a plastic bag on a fabric seat may make moving easier.
  • Reach with your right hand and hold the door frame or headrest. Place your left hand on the car seat or dashboard.
  • Slowly lower yourself to the car seat.
  • Slide yourself back onto the car seat.
  • Swing your legs into the car. Try to move one leg at a time. Keep your toes pointed upward.
  • Do NOT cross your legs!
  • Reverse these steps to get out of a car.
  • When taking extended car rides, make sure to take breaks every 30 to 45 minutes. Get out of car and walk/stand for a few minutes so you don’t become too stiff.

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    Benefits Of Effective Pain Control

    • Increased patient comfort. Every joint replacement patient has some degree of post-operative pain, and effectively managing that pain can significantly affect patient comfort.
    • Earlier rehabilitation. A patient whose pain is under control is more likely to get out of bed and perform rehabilitation exercises. When done under the guidance and supervision of a surgeon and physical therapist, post-surgical exercise can help reduce the development of scar tissue, increase range of motion, and increase the likelihood a successful recovery.
    • Patients who have undergone a joint replacement are at greater risk for developing a blood clot in a deep vein. When a patients pain is under control, he or she can move about and perform rehabilitation exercises, which improve blood flow and therefore decrease the risk of DVT.
    • Earlier hospital discharge. The sooner a patients pain is under control, the sooner he or she can return home.
    • Increased patient satisfaction. Patients who are able to be self-sufficient and return to their normal routine on schedule or ahead of schedule tend to be more satisfied with their joint replacement surgery.

    What Pain Can I Expect After Joint Replacement Surgery


    Sep 27, 2016 | Patient

    This article was medically reviewed by orthopedic surgeons,;Trevor North, MD, OS and;Nima Mehran, MD, OS.

    What pain can I expect after surgery? is a top question on peoples minds before signing up for a joint replacement. Regardless of the level of joint pain youre experiencing before surgery, the thought of adding more pain to your future is scary. Unfortunately, the typical pain experienced after hip replacement surgery and knee replacement surgery is rather unpredictable and can vary. As;Dr. Nima Mehran, orthopedic surgeon explains, No two knees are the same. Even if someone had little pain on a left knee replacement, it doesnt mean they will experience low pain on a right knee replacement. In other words, dodging or experiencing a high level of pain can be like winning the lottery or drawing the shortest straw.

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    Who Typically Receives Joint Replacement Surgery

    While more than 95 percent of total knee replacements are done for people who have osteoarthritis, the procedures may benefit people with other conditions, as well. Those who experience post-traumatic arthritis such as from a sports-related or accident-related injury to the knee or knee damage resulting from an infection, a bone tumor or a change in blood supply that results in bone damage may also be candidates for knee replacement surgery.

    Although osteoarthritis is also a common reason for hip replacement surgery, people who have any condition that deteriorates the ball-and-socket structure of the hip such as developmental abnormalities, childhood hip disorders, trauma, tumors or tissue death may also consider hip replacement surgery as an option to repair the joint.

    Those who have inflammatory types of arthritis, like rheumatoid arthritis, gout or psoriatic arthritis may also consider knee or hip replacement surgery.

    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:

    • Infection

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    Is Hip Replacement Surgery Safe

    Hip replacements surgery has been performed for years and surgical techniques are being improved all the time. As with any surgery, however, there are risks. Since you will not be able to move around much at first, blood clots are a particular concern. Your doctor will give you blood thinners to help prevent blood clots from occurring. Infection and bleeding are also possible, as are risks associated with using general anesthesia.

    Other less common concerns that you and your doctor must watch out for are:

    • Your legs may not be of equal length after the surgery.
    • You must be careful not to cross your legs or not to sit too low because the joint may be dislocated.
    • Pieces of fat in the bone marrow may become loose, enter the bloodstream and get into the lungs, which can cause very serious breathing problems.
    • Nerves in the hip area may be injured from swelling or pressure and can cause some numbness.
    • The replacement parts may become loose, break, or become infected.

    Talk to your surgeon about these risks before undergoing the procedure.

    How To Sit Down And Stand Up After A Total Hip Replacement

    What causes pulling pain in hip & knee after total hip replacement? – Dr. Hanume Gowda

    To sit after a hip replacement:

    • Back up to the bed/chair until the back of your knees are touching the bed/chair.
    • Reach your hands back for the armrests of the chair. Maintain your weight-bearing status!
    • Lower your body slowly into a seated position. Avoid bending forward at your trunk.

    While sitting:

    • Sit on a firm chair with straight back and armrests. Keep hips and knees at 90 degrees .
    • DO NOT sit on low, soft or overstuffed furniture that may cause excessive bending of your hip.
    • Follow the precautions and weight-bearing status as instructed by your doctor or therapist.

    To stand:

    • Scoot to the edge of the bed/chair. Avoid bending forward at your trunk.
    • With your hands on the bed or chair, push up to the standing position. Bring one hand at a time up to your walker.

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    Where Will I Feel Pain After Hip Replacement Surgery

    You can expect to experience some discomfort in the hip region itself, as well as groin pain and thigh pain. This is normal as your body adjusts to changes made to joints in that area.

    There can also be pain in the thigh and knee that is typically associated with a change in the length of your leg. This is one of the many reasons why its important to closely follow a physical therapy routine following your surgery. You will be asked to do various exercises during the day. Some patients continue to work with a physical therapist at home to learn how to correctly sit, stand, get out of bed, and walk. This process can be invaluable to get your mobility and strength back.

    While it is common to experience some pain at the site of your incisions, new advances in technology have made this aspect of the procedure much easier. Smaller instruments allow for incisions of just three inches, rather than the larger incisions that were necessary in the past. This improved technique allows for less damage to the muscle and soft tissue. This can reduce the level of pain you can expect to experience after surgery.

    Research: Doctors Are Looking For The Causes Of Pain After Knee Replacement And It Is Hard To Find

    The confusion as to what may be the cause of chronic knee pain after knee replacement is a cause of great concern not only among doctors but obviously among patients. We often find patients to be confused between what is normal and what is not normal after knee replacement.

    • Is some pain normal?
    • Are the clunking sounds normal?
    • Is the instability normal?

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    What Can I Do At Home After Hip Replacement Surgery

    There are a few simple measures that you can take to make life easier when you return home after hip replacement surgery, including:

    • Keep stair climbing to a minimum. Make the necessary arrangements so that you will only have to go up and down the steps once or twice a day.
    • Sit in a firm, straight-back chair. Recliners should not be used.
    • To help avoid falls, remove all throw rugs and keep floors and rooms clutter free.
    • Use an elevated toilet seat. This will help keep you from bending too far at the hips.
    • Keep enthusiastic pets away until you have healed completely.

    You should ask your doctor before returning to such activities as driving, sexual activity, and exercise.

    Patients Had Knee Pain After A Knee Replacement Because After The Fact It Was Determined That Knee Replacement Was The Wrong Surgery The Knee Was Not The Problem And The Patient Was Inappropriately Rushed To Surgery

    Precautions after Hip Replacement Surgery by Dr. Kunal

    Are you getting a knee replacement because of undiagnosed back and hip pain? Above we spoke about doctors looking for knee pain that was actually coming from the spine, hip, ankle, and feet.;The knee was perhaps not the problem and the patient was inappropriately rushed to surgery

    Doctors warn that in the case of chronic knee pain, a thorough examination is imperative in identifying the correct diagnosis. That sounds like common sense, but the truth is that the source of pain is often missed and treatment then will present a significant challenge with less than desired results.

    One study sought to understand why up to 20 percent of patients who undergo total knee replacement still have persistent pain and why secondary surgery rates are on the rise. ;Forty-five patients were studied. What the researchers found was somewhat shocking. The pain was not originating in the knee here is what they said:

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    Are There Complications To Thr

    • Total hip replacement is an excellent pain relieving procedure, and most patients receive approximately 95% pain relief.
    • Although complications are relatively rare , patients may experience a complication in the postoperative period. These include very serious and possibly life threatening complications such as heart attack, stroke, pulmonary embolism and kidney failure.
    • Infection is one of the most debilitating complications and often requires prolonged antibiotics with several additional surgeries to rid the infection.
    • A blood clot in the leg is also a relatively common complication requiring some type of blood thinner following surgery to reduce the incidence.
    • The implants used can also fail over time due to wear of the bearing components or loosening of the components from the bone, both of which usually occur over many years.
    • Another complication specific to hip replacement is dislocation of the joint that may require additional surgery if dislocation becomes recurring.
    • Leg length differences following surgery are also a possibility and may be difficult to avoid sometimes in order to insure a stable hip. Often this leg length discrepancy is mild are rarely needs treatment.

    Dos And Don’ts To Protect Your New Hip

    Whether you are experiencing severe pain after your hip surgery or not, it is important to pay attention to a few things to help accelerate the healing process. Be sure to work closely with your healthcare provider and physical therapist and follow their list of do’s and don’ts to avoid any complications after your surgery. Here are a few common things you should and should not do post surgery:

    The Don’ts

    • Do not cross your legs at your knees for up to 8 weeks of surgery.
    • Do not raise your knee up higher than the level of your hip.
    • Do not lean forward when sitting.
    • Do not bend forward to pick something from the ground while sitting.
    • Do not turn your feed outward or inward while bending down.
    • Do not bend excessively at the waist beyond 90 degrees.

    The Dos

    • Do keep the leg straight and facing forward.
    • Do keep your leg right in front of you while standing or sitting.
    • Do make use of a barstool or high kitchen while working in the kitchen.
    • Do apply ice packs to the affected area to relieve pain and swelling.
    • Do use heat before any exercise to improve your range of motion.

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    The Ligament Problem Is A Clue That For Some Patients Post Knee Replacement Pain May Be A Problem Of Overdoing It Even While In The Hospital Or Nursing Home

    In a study from October 2018, doctors writing in the;Journal of Pain Research, looking at why some people had excessive pain after knee replacement surgery asked if this was a problem of; overdoing it in the hospital following the surgery? The research measured the results of making patients progressively walk more steps in the hospital or nursing home up to 10 days after the surgery.

    These are surgeons and pain management specialists from leading hospitals and universities in Japan talking about patients soon after knee replacement during the surgery recovery.

    • Poor pacing during physical activity is associated with severe pain in postoperative patients
    • Over-activity results in a number of potential injuries to muscle fibers, nerves, bones, and ligaments. These injuries, as well as the repetitive experience of pain, will prolong pain and contribute to neurobiological mechanisms of peripheral and central sensitization.

    Are All Hip Replacement Implants The Same

    Hip Pain After Total Knee Replacement (An analogy for life)

    Most implants today have become more similar than different as surgeons and manufacturers have determined which designs work best. One variable that still remains is the;bearing surface. The bearing surface is the;ball and liner;that attach to the stem and cup that fix to the bone.

    The ball can be composed of either metal or ceramic, and the liner can be made of plastic , metal, or ceramic. The ball and liner can then be used in different combinations and are named for the respective ball liner combination .

    In 2015, the vast majority of bearings utilized a polyethylene liner with either a metal or ceramic head, with other combinations being used with less frequency. You can discuss these differences with your surgeon to determine which implant is best for you.

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    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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