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The Painful Total Knee Arthroplasty
Mitchell McDowell1, Andrew Park2, Tad L Gerlinger3
1Department of Orthopaedic Surgery, Kaiser Permanente Riverside Medical Center, 10800 Magnolia Avenue, Riverside, CA, USA.
The Orthopedic Clinics of North America
|January 17, 2016
Summary
Residual pain after total knee arthroplasty (TKA) has multiple causes. Comprehensive evaluation, including imaging and lab tests, is crucial for diagnosis before considering revision surgery.
Area of Science:
- Orthopedic surgery
- Pain management
Background:
- Total knee arthroplasty (TKA) can result in persistent pain.
- Identifying the cause of post-TKA pain is essential for effective treatment.
Purpose of the Study:
- To outline the diagnostic approach for residual pain following total knee arthroplasty.
- To emphasize the importance of a clear diagnosis before revision surgery.
Main Methods:
- Detailed patient history and physical examination.
- Radiographic evaluation of the knee and adjacent joints.
- Laboratory analysis and synovial fluid aspiration for cell count, differential, and culture.
- Consideration of advanced imaging when diagnosis is uncertain.
Main Results:
- A systematic diagnostic process is required for post-TKA pain.
- Laboratory and synovial fluid analysis aid in identifying infection or inflammation.
- Advanced imaging may be necessary for complex cases.
Conclusions:
- A thorough diagnostic workup is paramount for managing residual pain after TKA.
- Revision surgery should only be undertaken with a definitive diagnosis to avoid suboptimal outcomes.
