Chronic Pain After Knee Replacement is Surprisingly Common!

by Chris Centeno, MD /

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chronic pain after knee replacement

The most common reason patients seek knee replacement is for relief from pain. Despite that, an unacceptably high percentage of patients have chronic pain after knee replacement. What has been done to figure out how to prevent, or treat, chronic postsurgical knee replacement pain? A new study reveals the alarming truth…almost nothing!

Knee replacement is big surgery, fraught with big risks and complications the average patient signing the release forms often doesn’t fully grasp.  It’s very easy to understand that a “new knee” sounds like a much better idea than the old one that has caused so much pain, especially given the unrealistic expectations that saturate the media. But with alarmingly serious complications, at alarmingly serious rates, like heart attack, stroke, muscle death, cognitive and memory issues, ongoing metal toxicity and even possible cancer links from it, one would at least expect that after the lengthy recovery, there would be no more pain!

Towards that end a study sought to evaluate the effectiveness of predictive models to suggest preventative care for chronic pain after knee replacement, and for interventions in the management of chronic postsurgical knee replacement pain. To do this they did a systematic review of randomized controlled trials of adult knee replacement patients from 3 major databases.  They found not one study evaluating the effectiveness of predictive models in guiding treatment and improving outcomes.  Their search revealed only one study which tested a chronic pain intervention, a specific type of botulism injection, which worked for 40 days.  But no further study on that treatment has been done. The study concluded that developing evidence based care for knee replacement patients needs to become a research priority. Yikes!

The upshot?  Chronic pain after knee replacement is surprisingly common. Many things factor into outcome, but major studies put the numbers between 10 and 54%, with the average being around 30%.  One recent study found that 54% of patients had knee pain 5 years after knee replacement surgery, and 87% of those patients’ knee pain developed only after surgery! But the most alarming thing of all is, if you end up on the wrong side of those percentages, nobody seems to know how best to help you!

Category: Knee, Latest News

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10 thoughts on “Chronic Pain After Knee Replacement is Surprisingly Common!

  1. Cheryl Lorent

    Very interesting but not really very helpful. I don’t really care why, nice to know, but would prefer something to help with the pain. Exercise, injection, whatever.
    In my case the pain is just to the inside bottom of the kneecap. Very painful if the knee is extended fully. It started slowly shortly after the surgery and now two and half years later is constant and getting worse.

    1. Regenexx Team

      Cheryl,
      The pain in your knee may have nothing to do with your knee, i.e. it may be caused by a pinched nerve in your back, a damaged nerve in that area, or a patellar tendon that’s degenerated and chronically torn. You need to get in to see a Regenexx doc and get a diagnosis of what’s causing the pain, as without knowing that no amount of self help will be effective.

  2. Karen Miler

    I had a right TKR almost 2 years ago and I have worse pain now Thai. I did befor . I am only 46 years old and I feel like my life has been taken away from me, I looking for anything that will help! I honestly am at the point that I want my leg removed so I can get back to my life. I just recently got a stemulator placed in my spine ? For knee pain? Yea what ever I has helped with the burning in my leg and foot but not the pain in my knee. Is there anyone anywhere who can help me PLEASE.

    1. Regenexx Team

      Karen,
      It’s not uncommon for knee pain to originate in the back, which is why people with back issues (even asymptomatic ones) don’t do well with knee replacement. Please see: https://regenexx.com/blog/knee-replacement-outcomes-back-pain/ If you’d like us to take a look to see if we can help, please submit the Candidate form: https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/ and https://regenexx.com/blog/back-surgery-concerns-stone-age-spine-care/

  3. Arnold Cota

    I am fortunate to say I had both knees replaced several years ago by Dr Dust in Saskatoon,Sask. Have not had a single pain in either knee also know several people that had replacements. I am 74 now and still very active and have been since .I find this article hard to believe.

    1. Regenexx Team

      Arnold,
      That’s great news! It’s wonderful to be on that side of the statistics! We see patients from the 54% who have knee pain 5 years after knee replacement surgery, with 87% developing knee pain only after surgery, side!

    2. Stewart

      I had TKR 5 years ago and the pain after walking short distance is chronic far worse than it was before the op. i have been told there is nothing that can be done.

  4. Linette Woron

    I had TKR in 2014. The surgeon used xrays that were 5 months old. He came out after the surgery told my cousin, “ we had to make deeper incisions and make more sutures. The patella was off further to the left than I had realized. “ He told me he had trouble getting the patella to “ track right”, and I couldn’t use the motion machine in the hospital he didn’t want to tear any sutures. After that I was let go home but soon started a 4-5 year journey of chronic deep unending pain. HMO blames me generally for not doing enough exercise. But I know surgeon messed up my knee. Have been to PT , nerve blocks , radio frequency neurotomy, still on Oxy for the pain and can’t bend it very well. Wish I’d never had it.

  5. James e Bugg

    I have had 3TKR in the last 8 years and the pain is terrible most of the time.

    I have a pain pump also that really doesn’t do very much.
    i saw a doctor a few weeks ago at the ER and he said it looked to him the problem might be in my back. Anyway maybe there is some hope.

    1. Regenexx Team

      Hi James,
      Hoping you find some answers as back and knee issues are commonly related. Please see: https://regenexx.com/blog/low-back-and-knee-pain/ and https://regenexx.com/blog/knee-arthritis-low-back-and-knee-pain/ and https://regenexx.com/blog/unnecessary-knee-replacements/ Unfortunately, sometimes the joint replaced isn’t the source of the problem: https://regenexx.com/blog/hip-replacement-pain/ Our Houston Regenexx Provider may be able to help: https://www.texasinterventional.com/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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