Pain with a prosthetic knee

What pain should you expect with a knee prosthesis?

A Knee prosthesis is usually only used when there is considerable pain and a person affected is exposed to high levels of suffering.
The goal of Knee prosthesis surgery so it is natural to relieve the patient of this severe pain. Nowadays this is achieved in over 90% the cases when physiotherapy is carried out and the prosthesis is handled well.

However, it can rarely happen that the pain persists or worsens after the operation, and in some cases it can even go as far as Ankle radiate. If this is the case, the person concerned must see a doctor as soon as possible. It helps the doctor to find the cause of this pain faster if you have a so-called beforehand Pain diary leads, i.e. writing down precise information about the pain, for example when exactly it occurs, how long it lasts, how it feels, where it is located and so on.

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
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Further information about myself can be found at Dr. Nicolas Gumpert

The reason for a painful Knee prosthesis can on the one hand infection which can in principle take place after every operation. Due to modern surgical techniques and hygiene measures, this type of postoperative infection only rarely occurs, but it must be included immediately Antibiotics be treated. This can be done using X-rays and Laboratory values be excluded.

Pain after knee prosthesis surgery

If the pain does not occur immediately after the operation, but rather later, this can be an indication that the knee joint prosthesis has loosened. As a result of constant irritation of the joint, this leads to joint effusion, which then causes pain for the patient. Normally the life of a prosthesis is around 15 to 20 years, which is why you should pay particular attention to pain after this time. Such loosening can also be seen by a doctor on an X-ray, and even relatively early on, which is why it is of great importance to visit the doctor at regular intervals. Here, too, action must be taken as quickly as possible, since a loose artificial joint can permanently damage the bone and cartilage structures of the joint, making it more difficult to reattach or insert a prosthesis.

Otherwise, pain can occur again and again in everyday life with a knee prosthesis if the joint is exposed to particular stress, such as in certain sports or when climbing stairs. However, if the pain is limited to these special activities, these should be avoided by the patient as much as possible and there is not necessarily the compulsion to treat this pain.

Further information on this topic can be found at: Pain after knee surgery

Pain from loosening the knee prosthesis

An important reason for pain after knee prosthesis surgery can be the loosening of the prosthesis.
In principle, the implanted prosthesis material can always loosen, so this is not an atypical complication.

As a rule, however, the shelf life is 10-15 years. The loosening is then justified by natural signs of wear and tear.
Pain that occurs earlier should be clarified as it can be an indication of loosening of the knee prosthesis. The pain can be traced back to an inflammatory process in the knee joint. This inflammation in turn arises from the fact that there is abrasion and wear and tear on the implant and therefore small particles of material detach from the implant.
These get into the joint, where they cause an inflammatory process as a defense reaction of the body through a deposit. Cells of the defense reaction collect more and more in the space between the bone and the implant and thus create a gap. This gap formation means more free space and mobility for the implant, so that in this case one speaks of a loosening of the knee prosthesis.

An x-ray or a scintigraphy can be done to determine whether the pain is actually the result of the relaxation. As already mentioned, the loosening is accompanied by severe pain. Painkillers help to a certain extent and relieve the symptoms temporarily, but it is necessary to treat the pain trigger therapeutically yourself.
This means that the knee prosthesis must be removed and replaced. The inflammation can be reduced with medication, but the formation of a gap between the bone and the implant is irreversible.

Also read our topic: Pain after knee replacement surgery

Pain with a knee prosthesis due to restricted mobility

The indication of a knee joint prosthesis surgery (please refer: Knee prosthesis surgery), among other things, the existing restriction of movement is to be reduced or eliminated.
Nevertheless, these symptoms can still exist immediately after the procedure, accompanied by pain. The restriction of movement after the operation should be achieved through rapid mobilization in the form of rehabilitation measures with movement exercises (above all the ability to stretch) be prevented.

Another goal is freedom from pain, which for certain reasons explained below does not occur immediately or in every case.
In rare cases, during the rehabilitation measures, slight dislocations of the knee joint can occur, which can subsequently limit mobility.
There is also a risk of contortion outside of rehab. Especially at the beginning, those affected shouldn't expect too much. The regeneration of the knee joint takes time.
Despite regular physiotherapy or exercise, not all degrees of movement are possible to the full extent at the beginning, especially not without slight pain. The patient must be aware of this on the one hand so that they do not overestimate themselves and put too much strain on the knee and on the other hand to be able to classify possible pain.
It is quite normal that climbing stairs after a knee prosthesis operation causes pain, because the knee joint is not yet fully mobile and not capable of bearing loads.

The restriction of movement including the pain can also be a consequence of certain risks occurring. As with any surgery, there are general and specific risks.
A special risk of knee prosthesis surgery is the occurrence of adhesions or sticking of structures of the knee joint, which is associated with unpleasant pain. As a rule, this complication does not occur because special emphasis is placed on early mobilization after the operation, so that the likelihood of adhesions or adhesions is low.

However, if the patient does not follow the rehabilitation measures accordingly, the knee joint can lose mobility immediately after the procedure and become very painful.
In the worst case, a second operation has to be performed to remove any adhesions and to relieve the pain.

The pain caused by restricted mobility can also be secondary to a fall. The risk of falling is extremely increased after a knee prosthesis operation.
Immediately after the operation, those affected are not as mobile and less stable and safe in walking and standing. In addition, the knee joint is still stiff, which is why the movement exercises are so important. If a fall occurs, the knee joint is not very flexible and cannot compensate for a fall with strong pressure and force, resulting in a compression, contusion or fracture.
This in turn is accompanied by swelling, severe pain and the associated restrictions on movement. A final reason for pain can be the restriction of movement due to calcium deposits in the muscular structures of the knee joint.

Read about this too Rehabilitation after a knee prosthesis

Sports with a prosthetic knee

The Lifespan of a knee prosthesis has improved significantly over time and is now included approx. 15-20 years. Robust and well-tolerated materials enable resilience and a range of motion that correspond to those of the healthy knee joint in everyday life.

Since the collective of patients with an implanted knee prosthesis is getting younger and younger and therefore more and more physically active people are wearing the prosthesis, the question often arises as to which rules of conduct should be observed when exercising. Basically represents a knee prosthesis no reason dar, Avoid physical activity. However, the extent of the permissible load depends on several factors. The stability of the ligaments and muscle strength are just as important factors as the coordination of certain movement sequences. Patients who were in a weakened physical condition prior to the operation should then slowly relieve pressure, preferably under the guidance of experienced therapists.

Last but not least, that plays body weight plays an important role in terms of the durability of the prosthesis. The greater the patient's weight, the greater the forces acting on the newly used materials. From one BMI (Body mass index) from 30 should be a burden in the sense exercise very carefully respectively.

A absolute ban on sports prevails at Pain or instability of the affected joint. Exercise can only be started again when the artificial joint has sufficient function and stability. The guidance by muscles and ligaments must be guaranteed to prevent premature prosthesis failure.

Even with the choice of those exercised sport it means to exercise caution. Sports that involve jerky loads such as sudden stopping should be avoided. Rotational movements or sudden external forces can also damage the artificial joint. Previously practiced sports such as ball sports, dancing or martial arts should be avoided after implanting a knee prosthesis. Instead, those affected should like to exercise with moderate and continuous stress Nordic walking, light jogging or swimming hold.