Thursday, August 11, 2022

What Causes Pain Behind Knee After Total Knee Replacement

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Knee Pain Treatment In Boynton Beach Fl

Knee Pain After Total Knee Arthroplasty

Other issues that can cause persistent pain include bursitis, complex regional pain syndrome, and pinched nerves.

No matter the cause of your knee pain we can help you get rid of it, once and for all. Contact the post-op knee pain specialists at Personalized Painful Knee Replacement Institute in Boynton Beach, Florida, by calling 903-7448. You may also request your appointment now.

Who Should Consider Total Knee Replacement Surgery

It is usually reasonable to try a number of non-operative interventions before considering knee replacement surgery of any type. Prior to surgery an orthopedic surgeon may offer medications knee injections or exercises. A surgeon may talk to patients about activity modification weight loss or use of a cane.

The decision to undergo the total knee replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of knee pain. When basic activities of daily life–like walking shopping or reasonable recreational pastimes–are inhibited or prevented by the knee pain it may be reasonable to consider the surgery.

Back Of Knee Pain After Tkr


i had a tkr on 12/01 and still have a lot of pain and taking my analgesia regularly. The pain is mainly in the back of my knee now when weight bearing and a little under my knee cap. I find it difficult walking downstairs leading with my non tkr leg but can go upstairs consecutively. Does anyone else suffer pain in back of knee, is this normal? I’m beginning to think my knee will never be normal again.I just want to wake up in the morning and find that all the pain’s gone and i can walk normal.

3 likes, 55 replies

  • Edited 7 months ago

    My surgery was 1/7/16 and I have all your symptoms: pain in the back, unable to go down statist when leading wig my good leg and one more– severe pain over the lateral side of the knee (it primarily this pain that prevents going down stairs.

  • 3 years ago

    My bilateral TKR was on 12/11/16.

    I get stiffness at the back of my legs mostly at night. I still take painkillers occasionally especially when travelling.

    I find it very hard to turn in bed, but have now accepted that I will have to live with these nagging pains.

  • Edited 7 months ago

    I think I’ve been very lucky , reading people’s experiences, I’m now 19 weeks post op, pain free and back at work , also going to the gym 3 nights per week. Not pushing the legs too much, but doing well.

    Get the occasional bad nights sleep but generally ok.

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Pathophysiology And Etiology Of Pain

Pain is a normal manifestation of everyday life and serves as a protective mechanism for the body, causing the individual to react to try to eliminate the pain stimulus. However, excessive pain after a TKA can diminish or hinder quality of life. This form of pain typically originates in the peripheral nervous system .

The PNS consists of all the nerves outside of the brain and the spinal cord. It is made up of bundles of axons which are enclosed by connective tissue to maintain the continuity, nourish and protect the axon. Each axon in the PNS can be surrounded by a myelin sheath, called a Schwann cell sheath, and these two together form a nerve fibre. An axon can be myelinated once it reaches a thickness of one or two micro metre. The difference between a myelinated and non-myelinated nerve fibre is the conduction velocity . Nerve fibres can therefore be classified into different types depending on their diameter and conducting velocity.

The problem with pain receptors is that, unlike smell or taste for example, they adapt very little and sometimes not at all. The continuous excitation of nociceptors, therefore, tends to lead to a chronic aching pain. This increase in sensitivity of the nociceptors is called hyperalgesia.

What Are The Symptoms Of A Failed Knee Replacement

How to Manage Pain Swelling and Bruising After Total Knee ...

Symptoms of a failed knee replacement may include:

  • Pain, which can occur during activity or at rest
  • Swelling around the joint, or recurrent joint effusions
  • Feeling as though your knee wants to give out when youre standing, walking, or going up and down stairs
  • Noticeable warmth in the joint, long after your surgery was completed
  • Painful popping or scratching noises
  • A reduced range of motion and function
  • Inability to place weight on the leg

If you are experiencing any of these symptoms or other symptoms that cause concern, it is important to get evaluated by your surgeon.

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Symptoms Of Knee Pain

Suffering from knee pain is never fun. Before diving into some of the common causes of knee pain, lets explore the common symptoms. The severity of the pain can vary depending on the cause of the problem and the location.

Some common signs and symptoms of knee pain include swelling and stiffness, as well as redness, in the knee. Your knee may even feel warm to the touch. Other common symptoms include not being able to fully straighten the knee, weakness or instability, and popping or crunching noises.

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  • What Does Knee Replacement Surgery Recovery Look Like

    During knee replacement surgery, your doctor will make an incision before moving your knee cap and cutting away any damaged bone, cartilage, and joint surfaces. Artificial joints will then be attached and tested by bending and rotating your knee before your doctor closes your incision with stitches.

    Whether youre having a total or partial knee replacement will have an effect on your pain level and recovery.

    A traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. On the other hand, a partial knee replacement is much less invasive. Patients usually walk without assistance within two weeks. This is because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.

    After your surgery, youll follow weight-bearing guidelines. How much pressure your new knee can initially support will depend on the condition of your natural bone, as well as the type of prosthesis you have.

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    With Nowhere Else To Go Doctors Suggest Another Knee Replacement

    • Study: Early diagnosis is very important for the treatment of intractable pain following total knee replacement. A reoperation conducted without identification of a specific reason carries a high risk of failure.
    • With nowhere else to go, doctors suggest another knee replacement.
    • Second knee replacement operation with a high rate of failure.

    What Helps Pain After Total Knee Replacement

    Pain in Back of Knee After Knee Replacement

    Its vital to note that pain is often inevitable right after knee replacement surgery. However, you should also know that the success rate of such procedures is 90% to 95%. Successful implant placement also lasts for over a decade.

    With that said, there are many ways to manage and ease pain following knee replacement. Here is a general guideline, including a timeline, of what you can do to reduce knee surgery pain.

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    Personal And Economic Impact

    Chronic pain after TKA can affect all dimensions of health-related quality of life, and has been found to be associated with functional limitations, depression, anxiety, poorer general health, sleep problems and long-term opioid use.- Older people with chronic pain after joint arthroplasty can experience interference with relationships and become socially isolated, which is a risk factor for other problems and can limit their capacity to bring about change or to seek help for their pain.,, Some people experience considerable pain-related distress, and this is often highest in those who experience no change or deterioration in pain symptoms following surgery. Pain relief is the main expectation of patients undergoing TKA, and those who have continuing pain are often the most dissatisfied and disappointed with the outcome of their surgery.,, An overview of the biopsychosocial impact of chronic pain after TKA is provided in .

    Overview of the biopsychosocial impact of chronic pain after total knee arthroplasty .

    Introduce Gradual Movement To Your Knees

    Bracing can help shorten the time you need to get back to your feet unaided as it secures your knee. In this way, a post OP knee brace helps restrict your knee joint to protect it from flexing too much. As your recovery progresses, though, you can adjust the braces level of restriction.

    Its important to introduce gentle movements to your knee as soon as you can after your surgery. For starters, this helps prevent your knee from developing excessive scar tissue. So, by performing gentle knee exercises, you can keep knee stiffness at bay.

    To help prevent re-injuring your knee, though, its best to keep using your hinged knee brace. This way, you can give your knee more support and stability, preventing it from buckling.

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    When To Contact A Medical Professional

    • You cannot bear weight on your knee.
    • You have severe pain, even when not bearing weight.
    • Your knee buckles, clicks, or locks.
    • Your knee is deformed or misshapen.
    • You cannot flex your knee or have trouble straightening it all the way out.
    • You have a , redness or warmth around the knee, or a lot of swelling.
    • You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee.
    • You still have pain after 3 days of home treatment.

    Ongoing Pain After Knee Replacement: People Need Support And Encouragement To Seek Help

    Pain After Knee Replacement Surgery

    People with ongoing pain after knee replacement surgery may experience a sense of futility and believe nothing more can be done. A new study found that that one in five people report ongoing pain after knee replacement surgery, but many do not seek help in dealing with their pain.

    The researchers say that improvements in the information given before surgery could help. And it is important that clinicians acknowledge pain at follow-up appointments. This may encourage people to seek help to manage their pain through services such as physiotherapy, surgery, or medication.

    In this new study, researchers found that some patients did not want to undergo further treatment because they thought it would not work or be risky, or because they had other health problems to deal with. People were uncertain about what to do about their pain even after consulting their surgeon or GP.

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    Why Is My Calf So Tight After Knee Replacement Surgery

    Swelling as the edema or swelling starts to accumulate in the lower leg that fluid is pushing in as much as it pushes out.

    Imagine someone squeezing your muscles 24-hours a day, 7-days a week. That would start to become painful.

    Since you are not walking and moving as much as you normally would your swelling does not have the ability to move out of the lower leg and back into the system.

    * Recommendations: Some therapists will perform compression wrapping to move the fluid out of the lower leg. You may have also been told to elevate your leg to reduce swelling. Finally, as you become more mobile and start walking more the act of walking will help squeeze some of the fluid out of your ankle and calf.

    Knee Replacement Pain A Year And Beyond

    The goal of knee replacement surgery is to help you get back to the activities you love. Your doctor will encourage you to stay fit through activities like swimming, cycling, and even golf. This type of exercise will help you stay limber and pain-free.

    On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.

    The good news is that studies show more than 90% of total knee replacements are still functioning properly 15 years after surgery. Staying healthy and following the advice of your doctor will help you achieve these long-term benefits.

    While its possible for pain to persist for a year and beyond, it shouldnt be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee, but if youre suffering from ongoing pain after a year, always talk to your doctor.

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    How Long Does Knee Pain Last After Knee Replacement Surgery

    One of the most common questions we hear is, How long does pain last after knee replacement?

    Traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane while partial knee replacement surgery requires significantly less time. But there is more to consider when trying to figure out how long pain will last after surgery.

    How long the pain lasts after knee replacement surgery depends on a wide range of factors, before and after the surgery.

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    Possible Benefits Of Total Knee Replacement Surgery

    Knee Tendon / Ligament Pain After Knee Replacement

    Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.

    The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!

    Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.

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    Signs Of Knee Replacement Failure

    No one likes to hear the word failure when you are scheduled for surgery. Those of us who made the decision to have total knee replacement did so because we were looking forward to having a functional, pain-free knee.

    The last thing we wanted were complications that needed additional medical care or further surgery.

    Doctors are not perfect. When I was a youngster, I thought teachers, police and doctors could do no wrong. As I aged, I learned that everyone is human and can make a mistake. Even your surgeon.

    There are other factors besides physician error that can cause complications after surgery. In the sections below, I will discuss some things that could go wrong during the knee replacement process.

    Remember, there are several things that you can do prior to knee replacement surgery to improve the chances of a successful outcome. Building leg strength, stretching, exercising and weight management are a few pro-active steps you can do to increase the probability of success.

    My experience, as well as my discussions with TKR veterans, leads me to believe that the vast majority of knee replacement surgeries have a positive outcome.

    Preparation For Total Knee Replacement Surgery

    Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.

    Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.

    Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patients questions and concerns, as well as those of the family, are answered.


    The surgeons office should provide a reasonable estimate of:

    • the surgeons fee
    • the degree to which these should be covered by the patients insurance.

    Total Knee Replacement Surgical Team

    The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.

    Finding an experienced surgeon to perform your total knee replacement

    Some questions to consider asking your knee surgeon:

    • Are you board certified in orthopedic surgery?
    • Have you done a fellowship in joint replacement surgery?
    • How many knee replacements do you do each year?

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    In This Video Our Patient Jeannette Had Issues With Spinal Stenosis And Problems Post Knee Replacement

    • Jeannette starts discussing the knee replacement complications at 2:30 into the video. Jeannette is 81 years old.

    Jeannette describes a foot tingling problem. She cannot sit down and relax at the end of the day, it is uncomfortable for her to put her feet up or down because it is tingling. She had a nerve conduction study that shows an injury to her peroneal nerve.

    The peroneal nerve branches out from the sciatic nerve. As it provides sensation to the front and sides of the legs and to the top of the feet, damage to this nerve would result in burning and tingling or numbness sensation in these areas. Further damage to this nerve would also cause loss of control in the muscles in the leg that help you point your toes upward. This can lead to walking problems and possibly foot drop, the inability to lift the front of the foot or ankle. Knee and hip replacement are leading culprits in the cause of peroneal nerve injury.

    In Jeannettes case, she had two knee replacement surgeries in that knee. After the first knee replacement surgery, the implant started to protrude away from the limb. The knee replacement became loose. The second surgery to fix the first one occurred in 2015.

    • It was determined after examination that Jeannettes knee ligaments were loose. Her knee was hypermobile and unstable. This was causing pressure on her peroneal nerve. Knee ligament damage and weakness is also a complication of knee replacement surgery and is discussed further below.

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