Systematic Analysis of Painful Total Knee Prosthesis, a Diagnostic Algorithm

Document Type : CURRENT CONCEPTS REVIEW

Authors

Orthopaedic Hospital Stolzalpe Department of Joint Reconstruction A-8852 Stolzalpe, Austria.

Abstract

Remaining pain after total knee arthroplasty (TKA) is a common observation in about 20% of postoperative patients; where
in about 60% of these knees require early revision surgery within five years. Obvious causes of this pain could be identified
simply with clinical examinations and standard radiographs. However, unexplained painful TKA still remains a challenge for
the surgeon. The management should include a multidisciplinary approach to the patient`s pain as well as addressing the
underlying etiology. There are a number of extrinsic (tendinopathy, hip, ankle, spine, CRPS and so on) and intrinsic (infection,
instability, malalignment, wear and so on) causes of painful knee replacement. On average, diagnosis takes more than 12
months and patients become very dissatisfied and some of them even acquire psychological problems. Hence, a systematic
diagnostic algorithm might be helpful. This review article aims to act as a guide to the evaluation of patients with painful TKA
described in 10 different steps. Furthermore, the preliminary results of a series of 100 consecutive cases will be discussed.
Revision surgery was performed only in those cases with clear failure mechanism. 

Keywords

References

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The Archives of Bone and Joint Surgery
Volume 1, Issue 2 - Serial Number 2
December 2013
Pages 48-52

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History

  • Receive Date: 07 September 2013
  • Revise Date: 15 November 2014
  • Accept Date: 09 December 2013

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