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One of the most common orthopedic surgeries today is a knee replacement operation. This is usually done for advanced arthritis of the joint and ongoing pain. Many people obtain profound relief after undergoing this operation. However, a small percentage of patients will continue to suffer from chronic knee pain, even after a successful operation. This leaves patients in a difficult situation. The initial step should be an evaluation with the surgeon who performed the procedure. Historically, if the surgeon finds everything to be satisfactory, patients have been left with little remaining treatment options, other than chronic medication.
Over the past couple of years, there have been some new developments to help treat pain in this situation. One is a procedure in which the nerves that carry pain information away from the knee are ablated or destroyed with the use of a special needle. Studies have been done that are showing promising results in people with chronic knee pain or have had prior surgery. This may be an option for you if you suffer from chronic knee pain, have had knee surgery, or are not a candidate for knee surgery. This procedure is available in the pain clinic.
Another minimally invasive procedure that has shown some benefit for chronic knee pain after surgery is the use of dorsal root ganglion (DRG) stimulation. The dorsal root ganglion is a collection of nerves near the spinal canal that can be stimulated to provide relief in select conditions. There have been multiple publications in the medical literature that show promising results for this type of pain. The DRG stimulator is an implanted device beneath the skin that connects to multiple leads which conduct electricity to the stimulation target. The electrical signals interfere with the pain transmission, and produce decreased pain. This procedure is also offered in the pain clinic.
These interventions do not work for everyone and a full consultation in the pain clinic is a great way to find out what options might work in your individual situation.
Helpful Links:
- Learn more about DRG stimulators via the Neuromodulation tab
- Connect with others via the Joint Replacement group
- Learn more about Dr. Markus Bendel
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Its been 5 painful years since my tkr and now the surgeon thinks the knee replacement has come lose. Would that cause pain in my heel of the foot?
There's no one on this chat that can or should be commenting on what might cause pain, unless they are commenting on their own experience.
Hi @cobweb, you ask a good question that a physician who can examine you could investigate. You may also consider discussing some of the options that Dr. Bendel describes in this blog post to inquire if ablation or dorsal root ganglion (DRG) stimulation might be options for you. Do you have pain in the knee area as well in your heel? Has your surgeon indicated that the heel pain is or is not related?
Hello win sturgeon @cobweb we took your question to Dr. Bendel and he replied with this response:
"If the surgeon thinks that there is loose hardware, this is an entirely different circumstance than treating pain after a well-healed knee replacement. Your surgeon should be able to answer questions about whether the heel pain is related to the condition of the knee and what needs to be done in relation to the hardware."
Thanks, i did ask the question and a shoulder shrug was the response. So i will continue to look for answers and i do have an appt in late june with new surgeon.
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1 Reaction@krisluhman and @cobweb this all might be true if doctors had all the answers and they don’t. Just ask one whether they know it all and you’ll most likely receive similar answers. Our bodies are still a mystery in so many ways, healthcare science just keep finding new and amazing facts about our bodies. Try checking out the Institute of Human Anatomy on YouTube to learn more about our amazing bodies. Since knees take a long time to get to the point of needing replacement the wear and tear we put upon them is great. To expect an immediate fix with no pain is unrealistic in my eyes having suffered a back injury in 1988, fusion 1990 and now with OA, PN and chronic pain but I can walk 2 miles daily, exercise 2x a day and keep on moving. I still have a fair amount of pain and still on a narcotic for pain but I have no worries about my back. It will continue to deteriorate as I age and exercise. But if I don’t I’m a blob in pain instead of an active senior.
Hello…I myself am 5 yrs post op of total tkr. I still have pain getting up out of a sitting position and going up and down stairs. I had a revision and nothing changed. In my quest I had an mri which showed there are several gangoline cysts surrounding the implant. No one has seen this or knows why. The implant has nothing wrong with it. This is one for the books! I don’t think I can bring myself to have a third surgery if it won’t be successful and we know how that goes.
I feel for your situation, I am sorry.
My sister is a retired nurse, a head RN. She has seen it all in the hospitals she has worked in.
Her first worry about your problem is infection, which has become a regular problem for knee and hip surgeries in Canada since the operations have cut corners in procedures to save time and get more done for the annual cost in public health care in Canada to get "more for the money" in surgeries done.
She said infections used to be rare, until the demand was made to hurry up procedures. Now she says infections are now a common problem after these surgeries.
She has been a head Registered Nurse in rural hospitals in Manitoba province since the 1970s at 19 years old until retirement at 65 years old, and a very good one!
I get her to tell me how to solve all my bodily ailments personally, at my age of 65 now (2025). She is amazingly knowledgeable and thankfully one phone call away.
I really hope you ❤️ can resolve your problem!