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Causes of Aseptic Persistent Pain after Total Knee Arthroplasty
- Source :
- Clinics in Orthopedic Surgery
- Publication Year :
- 2016
-
Abstract
- BACKGROUND Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS Of the total 2,534 cases of primary TKA reviewed, 178 cases were classified as having aseptic persistent pain that was not resolved within 1 year after surgery. Except for the cases with periprosthetic fracture (56 knees), 122 cases of aseptic painful TKA were divided into two groups: intra-articular group (83 knees) and extra-articular group (39 knees). RESULTS In the intra-articular group, the main reasons for pain were aseptic loosening (n = 40), polyethylene wear (n = 16), instability (n = 10), recurrent hemarthrosis (n = 5), patellar maltracking (n = 4), tendon ruptures (n = 4), and stiffness (n = 2). In the extraarticular group, 10 knees (25.6%) were found to have nerve entrapment in the spine, 6 knees (15.4%) were found to have hip osteoarthritis or femoral head avascular necrosis. The reasons for persistent knee pain in the remaining 23 knees (59.0%) still remain elusive. CONCLUSIONS Persistent pain after TKA originated from pathology of extra-articular origin in a considerable number of cases in this study. Therefore, it is important to perform thorough preoperative evaluations to reduce pain resulting from extra-articular causes. Furthermore, meticulous surgical procedures and optimal alignment are required to reduce pain of intra-articular origin related to implant wear, instability, and patellar maltracking.
- Subjects :
- musculoskeletal diseases
Joint Instability
Male
medicine.medical_specialty
Periprosthetic
Chronic pain
Osteoarthritis, Hip
03 medical and health sciences
0302 clinical medicine
Femur Head Necrosis
medicine
Humans
Orthopedics and Sports Medicine
Arthroplasty, Replacement, Knee
Aged
Aged, 80 and over
030222 orthopedics
Pain, Postoperative
business.industry
Nerve Compression Syndromes
030229 sport sciences
Patella
Non-infective
Causes
Hemarthrosis
Middle Aged
medicine.disease
musculoskeletal system
Arthralgia
Nerve compression syndrome
Surgery
Pain, Intractable
Prosthesis Failure
Radiography
Knee pain
Total knee arthroplasty
Intractable pain
Female
Original Article
Implant
Aseptic processing
medicine.symptom
business
human activities
Subjects
Details
- ISSN :
- 20054408
- Volume :
- 9
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Clinics in orthopedic surgery
- Accession number :
- edsair.doi.dedup.....02ed0b0295c4467300e257635dfc718c