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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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