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August 2021

When Your Knee Is Still Hurting, Months After Total Knee Replacement

A Small Percentage of Patients Continue to Have Chronic Knee Pain After Knee Replacement Surgery – Options to Consider

 

If you suffer from knee pain, you know firsthand how it can impact the quality of your life. That dull, achy, throbbing, and deep pain that you feel when walking, or at night when you try to sleep, can make everyday life miserable.

Normal knee – with inflammation – with degeneration

Although these problems are more common as we get older, this can also be an issue for younger adults.

Knee joint problems along with accompanying pain may be the results of a sports injury or accident, or it can be attributed to osteoarthritis, also known as “wear and tear” arthritis. Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying knee cartilage.

Non-Surgical Treatments – and When to Consider Surgery

There is a broad range of non-surgical treatments that can help provide knee pain relief and maintain your mobility. These conservative approaches are Main Line Spine’s specialty.

From cortisone injections to viscosupplementation, to regenerative medicine and orthobiologics, physical therapy and a variety of other minimally invasive techniques, we consider every option available. If there is a non- or minimally-invasive treatment that can help you with your knee issues and related pain, Main Line Spine will find it.

For some patients however, non-surgical options just aren’t enough – and an evaluation for total knee replacement might be appropriate. This procedure is more formally known as a total knee arthroplasty. During a total knee arthroplasty, your surgeon replaces your knee joint with an artificial one.

Post-Knee Replacement Nerve Pain

Which brings us to the situation where you may have had a total knee replacement, and after the procedure and a normal period for recovery, you continue to have lasting pain. Your first step at that point is to make an appointment to see the surgeon who performed your knee replacement. He or she can evaluate your knee and check for possible complications from the surgery, such as an infection or a problem with the artificial joint.

But there are occasions where surgeons are unable to uncover the cause of ongoing pain after knee replacement surgery. Many clinical studies attribute this chronic pain to be the result of swelling (inflammation), damage to one or more peripheral nerves around the knee or other non-specific issues.

In the past, when this chronic pain occurred, patients were left with few treatment options other than taking pain medication. Over recent years, however, a variety of new options have been developed to treat chronic pain after knee replacement surgery.

Main Line Spine considers each of these newer interventions as potential alternatives for reducing chronic pain after knee replacement. One of the more promising approaches we use to treat this pain is utilizing Peripheral Nerve Stimulation.

Peripheral Nerve Stimulation (PNS)

Neurostimulation lead

Peripheral nerve stimulation is an FDA-cleared non-opioid pain management system used to treat chronic and acute pain. This approach involves placing an extremely small lead wire near the peripheral nerve that is causing you pain in your knee. Ultrasound imaging is used to guide placement of the lead during an outpatient procedure.

The lead is connected to a very small stimulator. Patients can adjust stimulation and customize its output using a small remote controller. When the stimulator is turned on, patients generally feel a comfortable tingling sensation over the targeted nerve. That stimulation masks or prevents pain signals from reaching your brain.

Peripheral nerve stimulation technology has been advancing at a rapid pace in recent years. Configurations of different systems vary widely. Some are intended for long term use, and others are designed to be used for short periods before removal. In fact, there are some systems that are used for only up to 60 days, and after removal of the device, significant and sustained relief continues.

Which of these systems might be best for your knee pain? Main Line Spine doctors consider multiple stimulator options when evaluating each individual situation. The determination of the most promising option for your chronic knee pain will be determined in discussion with your doctor.

Evaluating Peripheral Nerve Stimulation and Other Chronic Pain Alternatives

These chronic knee pain alternatives do not work for everyone. There normally is an involved process to determine what options might work for each individual situation.

If you’re interested in learning more, make an appointment at Main Line Spine for a full evaluation and consultation. A specialist on our clinical team can review your condition and discuss what might work best for your specific knee pain issues.

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