Post TKR (Total knee replacement) chronic pain
Pain relief is the main expectation of patients undergoing TKR, and those who have continuing pain are often the most dissatisfied and disappointed with the outcome of their surgery. Chronic pain after TKR is best defined as pain that is present and bothersome at least three to six months after surgery. Despite a good outcome for many, a considerable proportion of patients have chronic pain after TKR. 10% to 34% of patients report unfavourable pain outcomes at between three months and five years after total knee replacement. Chronic pain after TKR can affect all dimensions of health-related quality of life, and has been found to be associated with functional limitations, depression, anxiety, poorer general health, sleep problems and long-term opioid use.
Risk factors associated with chronic knee pain after surgery
- Severe knee pain before surgery
- Chronic pain elsewhere in body before TKR
- Depression, anxiety
- Catastrophizing pain
- Comorbidities like hypertension, diabetes
- Severe pain immediately following surgery
Causes of knee pain following TKR
- Muscle spasm
- Nerve impingement
Other reasons could be infection, complex regional pain syndrome, implant failure etc.
Investigations
Most causes of chronic pain following TKR can not be detected on any investigations but to rule out implant related issues X ray can be checked. Blood investigations like complete blood count, C-reactive protein is checked if infection is suspected.
Treatment
1) Physiotherapy exercises
2) Ultrasound guided dry needling
3) Pulsed radiofrequency of nerves around knee joint
4) Cooled radiofrequency ablation
5) Re do surgery in cases of implant failure.
If you are suffering from chronic pain following knee replacement surgery connect with us on 9823743726 / www.drpriyarathi.com / www.nonsurgicalpaintreatment.com
