How can one resolve knee pain even after a knee replacement surgery?

Hi, thank you for the questions. The whole aim of knee replacement surgery is to remove pain. So it seems the left replacement was a success, and the right hasn't achieved its desired results.

She should find out from her orthopaedic surgeon why her right side is still so painful. Knee pain after knee replacement can be due to several reasons.

The most important should be whether there are any potential problems/complications with the replacement itself, and this could be infection, cement fracture, malaligment of the implants etc.

Her orthopaedic surgeon should assess her knee and do the relevant investigations do identify any potential problems. A revision knee replacement is one alternative if the identified cause requires a revision.

Knee pain can also be caused from painful tendons, and if physiotherapy doesn't improve the symptoms, a specialist that treats pain would be a useful person to see.

They can do injections to relieve the pain if necessary. Reducing her weight would also help, as this reduces the loading on the knees, and would help to relief some pain.

Hope this helps,

Best regards

Dr Sean Ng

Thank you for your question. Persistent severe pain after a right knee replacement is abnormal especially when her other knee replacement was doing fine.

I'd strongly advise you bring your grandmom for a checkup and we'll need to do a thorough investigations including X rays, blood tests and advanced imaging (MRI/ CT) to find out what is the cause of this persistent pain. The cause of persistent pain would include infection, implant malposition, cement fracture or referred pain.

Only after the cause of the persistent pain is identified then we can talk about the treatment. If it's due to infection/ implant malpositioning/ cement fracture, revision knee replacement might be the only option to solve the persistent pain.

A "blind" revision knee replaccement surgery is not recommended if the cause of the persistent pain cannot be identified.

Please check with her original orthopaedic surgeon about the cause of the persistent pain and I will be most glad to provide a second opinion for your grandma.

Cheers,

Dr. Henry Chan

Thank you for your question. This is certainly one where consultation from an Orthopaedic surgeon with experience in arthroplasty is necessary - in terms of the knee itself. Perhaps you could share why a repeat operation was required and how long ago it was undertaken?

From a pain perspective, is she taking regular analgesia for the symptoms and did she undergo rehabilitation post-operatively?

This might improve her strength and ability to mobilise.

From a weight perspective, has she consulted a dietician to look at her intake? Equally, has she considered non-impact/non-weight bearing exercise to help with weight loss?

Finally, have you considered alternative therapies for pain? I work very closely with an acupuncturist who often sees my patients with pain symptoms - it can help considerably.

Bw

Dr Dinesh