Persistent pain after TKR I see patients operated elsewhere who have persistent pain after TKR. They had hoped to get permanent pain relief . However their expectations are belied when pain persists. Pain after the first month is a definite cause of worry. Some causes are poor rehab, low pain threshold, effusion, poor muscle strength. Other major causes of worry are -
Infection is the most dreaded complication after a TKR. The consequences of an infection are disastrous needing removal of the infected prosthesis, cement and a revision knee replacement. Bone loss may occur and the second operation is more risky than the first. It is therefore important to carefully choose the surgeon and the hospital. Infection can occur per-operatively or post-operatively. They can spread from the skin,atmosphere oral cavity, urinary tract or the gut.
Loosening occurs due to malalignment, wear or technique. Diagnosis is by clinical exam, knee joint aspiration, blood tests, x rays and bone scan. Treatment depends on the cause. It may range from adequate rehab, MUA to revision.
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