My knee still hurts after surgery…

May 15, 2019 | Markus (Mark) A. Bendel, M.D. | @markusabendelmd | Comments (12)

Knee after surgery

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.

 

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This was a very interesting note regarding post-surgical complications after knee replacement or surgeries. Several procedures are new to me. I am a retired nurse. I have had 3 surgical procedures on my right knee due to a bad compression fracture. The surgeries were with titanium fixation, not a total replacement. The procedure had to be redone for 2 additional surgeries. The last surgery, my ortho doctor put a full cast on my leg from my toes up to my hip. Well, it finally healed. Needless to say - my knee still hurts, but I am 70 years old, and I treat it with walking, creams, lotions, and medication. At least I can still walk, and I am grateful to my surgeon. Good luck to you, my friend.

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Profile picture for kwblair @kwblair

5 years post total knee replacement pain has never let up worse at night. I’ve tried: PT, Chiropractor, Cortisone shots, nerve block, ablation made it worse - no help. Joint functions fine. My orthopedic surgeon is perplexed, my cartridge was destroyed by the cortisone shots from March not bad two shots later bone on bone in June. He thinks I should have waited longer given the bone on bone a chance to deaden the nerves. Another Orthopedic Surgeon said he sees nothing in spine that would require surgery.
I tried Gabapentin for months no help. I have a freezer in my bedroom have to use gel packs constantly. Could t be nerves cut? During surgery? I’ve had MRI and CT’s nothing mentioned as being out of order. I’m
Perplexed.

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@kwblair consider acupuncture next?

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