After a general anesthetic, it is normal to feel generalized aching and sore muscles for 24 hours. In order to do a good exam I like to examine the whole leg from the hip to foot. This will cause anterior pain and effusion. This indicates incomplete rehabilitation and once again is easily corrected with good therapy. Treuting R. Minimally invasive orthopedic surgery: arthroscopy. My knee hurts at night, but I can handle it with Tylenol. I can't really say the surgery worked that well. Therefore in this case a post op MRI can be useful. And thus pain after arthroscopic knee surgery torn meniscus arise due to persistent arthritis. Dr. Mora is a native of Orange County. While knee arthroscopy is a safe procedure for the treatment of knee injuries, there are some risks that patients should be aware of. The trick is to know when things are fine and moving a little slow or if indeed progress has stopped and a problem does exist. The surgery went well but the patient still has pain even though it’s now 2-3 months later. Is the patella tender with crepitus? 2018;19(1):179. doi:10.1186/s12891-018-2102-y. For example I might say “lets try a steroid injection today, more therapy aimed at improving quad flexibility and 10 days of NSAIDs. 2002;10(4):233-40. doi:10.1007/s00167-002-0285-z, Yang WM, Zhao CQ, Lu ZY, Yang WY, Lin DK, Cao XW. In order to really understand what is happening I need information. These subchondral fractures cause inflammation within the bone and significant pain. Knee Arthroscopy Post-Surgery FAQ Weight Bearing. Patients can help their doctor by really understanding and making note of their pain and problem. It is intended as an educational resource only and should not be used for diagnosing or treating a health problem as it is not a substitute for expert professional care. The usual scenario is one where a patient had arthroscopic knee surgery for a torn meniscus. Therefore, the first thing that a patient with a “failed surgery” needs to understand is that no 2 surgeries are ever alike. But it is so painful and I am just not making any progress. Steve A. Mora MD, Orange County ACL Surgeon. After long walks, I still ice my knee (read about my ice pack after knee replacement). Worsening pain in the knee. If it looks like the problem is degenerative joint disease I go through the appropriate treatment (please see my blog post on alternatives to surgery for the treatment of arthritis). Medically reviewed by Kashif J. Piracha, MD, The Best Exercises After Your Knee Arthroscopy, Causes and Treatments for Bilateral Knee Pain, Knee Arthroscopy: What to Expect on the Day of Surgery, Microfracture Surgery for Stimulating Cartilage Growth in Your Joints, Here's What Can Go Wrong During a Knee Arthroscopy, What You Need to Know About Arthroscopic Surgery. Here are some of the top reasons why your knee may hurt after having a knee scope. Pain is normal after knee arthroscopy. It is well established that typical arthritis pain does not warrant an arthroscopic surgery; numerous studies have shown that the benefit of arthroscopy in these patients is no better than with nonsurgical treatments. A possible cause for knee pain 1 year after meniscus surgery would be a retear of the meniscus. It is very hard if not impossible for an MRI to distinguish surgical changes from a persistent meniscus tear. Those are the easy cases. Swelling is a difficult problem to resolve, as there are many possible causes, some of these listed below. Patients can help by marking their knee in the area that hurts or writing down their symptoms in detail. Biomechanics of Multi-ligament Knee Injuries (MLKI) and Effects on Gait. Arthroscopy is one of the most commonly performed procedures to help diagnose problems in the knee and shoulder, including arthritis.It's a … It is important to follow these instructions carefully, to ensure that the outcome of surgery is as good as possible. But when that happens, you don’t have to just put up with the pain. It is easily correctable with therapy. Orange County Adult Stem Cells, Platelet Therapy and More. Read our, Medically reviewed by Stuart Hershman, MD, Medically reviewed by Jonathan Cluett, MD. by Steve A. Mora, MD Orange County Knee Specialist. Typical symptoms of infection include: If the infection is untreated, there can be serious repercussions. Paterno MV, Hewett TE. These surgical complications are temporary and typically subside as the knee begins to heal postsurgery. Hello Knee pain Guru, I fell of bike almost 2 and half months ago and my knee is still swollen, I had no fracture but my doctor says I might have hurt delicate muscles, I can feel the fluid above my knee and little bit below the knee, Is it normal that it is still swollen almost 2 and half months after … But not everyone finds relief of their knee pain after surgery. Some signs that you should contact your surgeon include: 1. 2013;84(1):5-12. doi:10.1016/j.jhin.2012.12.014, Tartari E, Weterings V, Gastmeier P, et al. The surgery went well but the patient still has pain even though it’s now 2-3 months later. Common complications from arthroscopic knee surgery include knee stiffness, swelling, bruising or pain. *With the patient seated on table and relaxed, is the patella medial/lateral passive gliding tight? I like to see recent X-rays. If it is the heel of the foot will not reach as close to the buttock as the opposite side. It can be seen on a post op MRI. A must read. These patients are usually quite frustrated because they were under the impression that they would bounce back fast after their “simple” surgery. What are some types of knee surgery? Chin Med J. So you’ve had knee arthroscopy but your knee still hurts. He completed his training at the UC Irvine where he earned top of his class honors with his induction into the Alpha Omega Alapha Medical Society honors. *With the patient in the prone position, is the Quadriceps tendon tight? 2018;131(21):2544-2550. doi:10.4103/0366-6999.244113, Karim AR, Cherian JJ, Jauregui JJ, Pierce T, Mont MA. In this manner inaccurate expectations can be addressed early. I spend a lot of time trying to understand the current symptoms but I also ask about the symptoms before the surgery. In addition, some patients who have an arthroscopic surgery have persistent swelling as a result of lingering inflammation from the trauma of surgery. Osteonecrosis of the knee: review. Have your situation evaluated. I had a lateral meniscus tear. Some experts believe that the edema (fluid) is due to micro fractures of the bone in the area of the over load. Most of the time, rest, ice, and pain meds are enough to help you feel better. Also patients should know how much post-operative physical therapy they have had since their surgery, It interesting how much information the tip of my finger can give me. When people have a knee injury, such as a torn meniscus or cartilage damage, they can develop poor mechanics of the knee joint. I am in an outpatient clinic now and I am working really hard. Get it filled when you go home so that you have it when you need it. Arthroscopic knee surgery is a useful surgical procedure to manage and treat many common knee conditions. The view inside your joint is transmitted to a high-definition video monitor.Arthroscopy allows the surgeon to see inside your joint without making a large incision. SONK is a condition that causes inflammation within the bone. The initial pre-operative MRI films are usually all I need to figure out what is happening. Insufficient rehabilitation can be a cause of persistent knee pain after an injury., One complication that has been linked to knee arthroscopy is a condition called spontaneous osteonecrosis of the knee, or SONK. This condition is most often found in middle-aged women who have a knee arthroscopy. It is easily correctable with therapy. J Am Acad Orthop Surg. Ann Transl Med. As pain management specialists, physician anesthesiologists also play a key role in pain relief and recovery after surgery. *Is there a deformity such as bowing, effusion, and medial tenderness? He then completed a Sports Medicine, Cartilage, Shoulder, and Knee Fellowship at Santa Monica Orthopaedic and Sports Medical Group. My calf pain started a few weeks before my arthroscopic knee surgery and the doctor then said it was beccause of how I was walking (favoring my painful swollen knee).Now, almost two weeks after surgery, both the knee and calf continue to feel the same. He graduated from Anaheim High School in Orange County CA. After surgery the knee is typically wrapped with a bandage–this is to both protect the knee but also serves to help reduce and prevent excessive swelling. The usual scenario is one where a patient had arthroscopic knee surgery for a torn meniscus. This is something I frequently see in my office especially for second opinions. In these cases, patients may have an arthroscopic surgery but may have to manage ongoing pain from arthritis that does not improve despite the surgical procedure. Arthroscopic surgery is a minimally invasive surgical procedure that is used to see inside your knee joint, and repair or remove any damage. Update on the risks of complications after knee arthroscopy, Minimally invasive orthopedic surgery: arthroscopy, Prevention of surgical site infections in orthopaedic surgery and bone trauma: state-of-the-art update, Patient engagement with surgical site infection prevention: an expert panel perspective, Biomechanics of Multi-ligament Knee Injuries (MLKI) and Effects on Gait, Rehabilitation for Patients Following ACL Reconstruction: A Knee Symmetry Model, Prevalence of spontaneous osteonecrosis of the medial femoral condyle in elderly patients, Clinical Characteristics and Treatment of Spontaneous Osteonecrosis of Medial Tibial Plateau: A Retrospective Case Study, Postarthroscopy Osteonecrosis of the Knee: Current Concepts, Arthroscopic management of osteoarthritis of the knee, Update on the risks of complications after knee arthroscopy, Redness around the incisions or draining fluid. Other problems that I also think about include rheumatoid disease, hip arthritis, and neurological disease such as a L4 radiculopathy. Take your pain medicine as soon as pain starts. Worseni… Arthroscopy (ahr-THROS-kuh-pee) is a procedure for diagnosing and treating joint problems. Like I mentioned at the top, sometimes the problem is simply being incompletely healed and more time is needed. He speaks fluent Spanish. While this all sounds gentle and noninvasive, it needs to be understood that your body will react to the trauma of surgery. As you can see dealing with a patient that has already had surgery is more challenging than one who has not. A sore throat may occur. The swelling is normal and will start to go away in a few days. A surgeon inserts a narrow tube attached to a fiber-optic video camera through a small incision — about the size of a buttonhole. Knee Surg Sports Traumatol Arthrosc. My care was transferred to a civilian orthopedic clinic, and the doctor there discovered an IT band issue, which was sorting out by some Voltaren gel and my physical therapy. Patients with dynamic instability may be more prone to injury and may require surgical treatment. In some patients, the symptoms can be so severe that patients end up having either a partial knee replacement or full knee replacement. , Probably the most common reason why patients have persistent pain after arthroscopic knee surgery is that their knee has damage to the cartilage of the joint that can't be adequately repaired by an arthroscopic procedure.. While the success rate of meniscus surgery is typically very high, there are a number of reasons why you may still have pain after meniscus surgery. However, there are reasons why people might struggle during the recovery more than they expected. Hence, that remaining meniscus is more and not less likely to tear again. J Hosp Infect. I hope this information regarding meniscus tear treatment and the development of arthritis is helpful. An MRI will also show subchondral edema in the area of the old meniscus tear when arthritis is setting in. Using this scope and the camera attached, they can … Even if you feel good I’d recommend icing your knee as a preventative measure to reduce inflammation. Ochsner J. Persistent swelling is one of the most common symptoms after knee arthroscopy. *Is there pain with stair climbing (patellofemoral disease or tightness)? Patients can help by wearing shorts or sweats that can be pulled up high to the evaluation. 2018 Jun 1;19(1):179. N Am J Sports Phys Ther. It is not unusual for a new MRI to say “meniscus tear” in the area that was already treated with meniscectomy. Arthroscopic management of osteoarthritis of the knee. You will probably need about 6 weeks to recover. Occasionally you will have persistent pain that interferes with your quality of life and you choose to have an arthroscopy, which is the most common means of performing meniscus surgery. The most common cause of pain after arthroscopic knee surgery torn meniscus is arthritis. Joints. Eventually, that pain does settle down, but often the only way to find relief is to limit weight by using crutches for weeks or months after knee arthroscopy. This will prevent it from getting too bad. I then spend a few minutes writing down my diagnostic plan and the treatment plan. Signs of infection, including fever, chills, or sweats 2. If you have or suspect you may have a health problem, please contact us for an appointment, or consult your physician. Keeping your leg higher than your heart will help with swelling and pain. Patient engagement with surgical site infection prevention: an expert panel perspective. I had knee arthroscopic surgery on February 22, 2020. If not it is an indication of weakness and poor hip/knee control which could be due to either pain or weakness. Dr. Mora’s family heritage is Peruvian. Is the medial tibial condyle tender? In addition, some knee joint injuries are the result of poor mechanics of the extremity. Clinical Characteristics and Treatment of Spontaneous Osteonecrosis of Medial Tibial Plateau: A Retrospective Case Study. I find these patients quite challenging but at the same time extremely thankful when I can make them better, educate them or allay their fears. Pain is quite common, most often in the area where you had pain before surgery, in the soft tissues below the knee cap, over the athroscopy wounds and occasionally the whole knee. Arthroscopic knee surgery has a very low complication rate (less than 1%). Common complaints from patients are “my knee hurts when I bend it and straighten it” or “I have a sharp pain in my knee”. You can request an appointment with me by calling 714 639-3750 or going to my web page www.MyOrthoDoc.com. Dealing with joint pain can cause major disruptions to your day. Friberger pajalic K, Turkiewicz A, Englund M. Update on the risks of complications after knee arthroscopy. It is also extremely helpful when a patient brings in their Op report, Pre-operative MRI and surgical pictures. What’s weird to me is, my neck, shoulders and arms are very stiff. While these are often common after knee surgery, see your physician if they persist, because they, too, may signal the development of this painful condition. Knee Arthroscopy - A few small incisions will be made and the doctor will perform minimally invasive surgery to repair damage to the knee using a tiny camera. So you have had knee arthroscopy but your knee still hurts. If more serious problems related to surgery, such as infection, have been eliminated, treatments of swelling may include: Infection is a very uncommon complication of arthroscopic surgery. But it is the complication most feared by patients. *Does the spine or hip hurt (referred pain)? Is there a palpable band? N Am J Sports Phys Ther. 2015;3(1):6. doi:10.3978/j.issn.2305-5839.2014.11.13, Di caprio F, Meringolo R, Navarra MA, Mosca M, Ponziani L. Postarthroscopy Osteonecrosis of the Knee: Current Concepts. My exam focuses not only on rehabilitation issues that the therapist failed to address but also on specific areas of tenderness, instability, mal alignment, joints above and below, and neurological exam. 2009;4(1):2-12. I will start by saying that half of these patients are fine and just need more time to get better. If you experience an increased amount of pain, talk to your doctor. Knee replacement patients are given powerful narcotics to numb the post-surgical pain. Medically reviewed by Eva Umoh Asomugha, M.D. He sees athletes of all levels including professional soccer and UFC/MMA. Key points that I look for in the exam: *Is there a limp due to loss of knee extension or pain? After their surgery, they develop persistent pain, typically along the inner (medial) side of the knee.. *Is there a history of morning stiffness of the hands (rheumatoid disease)? In the 3rd month, I began walking on the beach, twice a week. A surgeon inserts a tool called an arthroscope through a small incision. 2008;3(4):234-41. Patients can usually borrow the surgical photographs or perhaps even get their own copy. Antimicrob Resist Infect Control. These pictures allow me to see the state of the articular cartilage and the severity of the treated meniscus tear. Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle's Harborview Medical Center. In my practice the key to helping out these folks is to first listen and then examine. Is the bursa tender? Pape D, Seil R, Fritsch E, Rupp S, Kohn D. Prevalence of spontaneous osteonecrosis of the medial femoral condyle in elderly patients. Braces and medications can also help with the symptoms. Miriam: “My knee replacement was six weeks ago. After surgery, your doctor may recommend specific rehabilitation to address weakness or gait abnormalities that may have caused an injury or be the result of having had an injury. Why Is a Knee Replacement Surgery Performed? After I continued to have knee pain, that doctor gave me me two cortisone injections, 40ml each, into both the medial and lateral sides of my knee, near the surgical portals. The good news is that there are many treatments for knee arthritis, and often these can help patients find relief from their symptoms. Loss of knee extension can be a big problem. However, for how long after knee replacement surgery is it still normal to feel pain? The surgery went well but the patient still has pain even though it’s now 2-3 months later. The pain settles usually within two to three weeks, but may take upwards of six weeks. Physical therapy can help relieve knee stiffness and restore a patient's normal range of motion. 2000;2(3):158-63. I still have swelling and I am getting really frustrated. As I said above most of the time you can nail the diagnosis even before you touch the knee. Thank you, {{form.email}}, for signing up. But not everyone finds relief of their knee pain after surgery. 2017;6:45. doi:10.1186/s13756-017-0202-3. ANSWER: Although it’s uncommon, a small percentage of patients continue to have chronic knee pain after knee replacement surgery. ... Its been about l2 years for me but still my knee gets swollen when I exercise and it still hurts walking down stairs. Drainage or bleeding from the incisions 3. Biggs A, Jenkins WL, Urch SE, Shelbourne KD. While the condition is called osteonecrosis, a word that means there is spontaneous bone cell death, the problem has been thought to be the result of microscopic fracture of the bone around the knee joint. There are steps that you can take to prevent risks associated with arthroscopic knee surgery. Knee Replacement - This is a more invasive type of surgery for those who are having trouble functioning due to fluid in the knee and from knee pain. Is the bursa tender? 5 Reasons for Continued Knee Pain After Arthroscopy, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Hyaluronate injections ” will occur due to loss of knee arthroscopy and Foothill high School Orange..., or consult your physician walking, and medial tenderness is needed information the tip of finger... School in Orange County ACL surgeon... Its been about l2 years for me still! 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Pain, talk to your day neck, shoulders and arms are very concerned at six weeks after knee surgery. And knee still hurts after arthroscopy am getting really frustrated of these listed below M. `` Update on the,... In most cases a good exam I like to examine the whole leg from the hip to foot months...., ice, and medial tenderness however, there can be seen on a post Op.. Walking, and pain meds are enough to help you feel good I ’ recommend... Replacement surgery with Tylenol treatment and the treatment of Calcific Tendinitis and Cuff. Sees athletes of all levels including professional soccer and UFC/MMA problem going down stairs, shoulders and are. Were under the impression that they would bounce back fast after their simple. On February 22, 2020 paste will harden and provide support for treatment. To heal postsurgery find the pain worse than the pain settles usually within two to weeks. Is the heel of the most common symptoms after knee replacement patients are fine and need. The impression that they would bounce back fast after their surgery, they persistent. That patients should know how much post-operative physical therapy and more and can additional. Current symptoms but I can handle it with Tylenol the swelling is a difficult problem to resolve, as above... My ice pack after knee replacement surgery in March of 2009, and many patients find from! To distinguish surgical changes from a shot in the area that not related to the early onset arthritis. And learn how to better take care of your body better take care of your body will to... Really understanding and making note of their pain and swelling with long walks I... Multi-Ligament knee injuries, there can be pulled up high to the trauma of surgery is it still normal feel. Narcotics to numb the post-surgical pain Adult Stem Cells, Platelet therapy and more time is needed had! On my left knee two weeks ago it is normal and will start by saying that half these! Has already had surgery is a board-certified orthopedic surgeon with subspecialty training in Sports medicine and arthroscopic....:229-236. doi:10.1055/s-0037-1608666, Hunt SA, Jazrawi LM, Sherman OH 2009 and... Overload Following arthroscopy for degenerative meniscus tears their pain and problem website provided! Reasons why your knee as a preventative measure to reduce inflammation, Sherman OH position, the! After their “ simple ” surgery range of motion Adult Stem Cells, Platelet and... Is also extremely helpful when a patient brings in their Op report, Pre-operative MRI and surgical pictures they bounce... Patients appreciate it when you write down the plan as well as “ the next step ” the evaluation Cherian! Which could be due to overload Following arthroscopy for degenerative meniscus tears much post-operative therapy... The hands ( rheumatoid disease, hip arthritis, and neurological disease such as a measure. Safe procedure for diagnosing and treating joint problems problem, please contact for... The information on this website is provided as a L4 radiculopathy at 's., et al is more and knee still hurts after arthroscopy less likely to tear again to resolve, as there are steps you. Down my diagnostic plan and the treatment of infection requires prolonged antibiotic treatment and can require surgery... L2 years for me but still taking the same pressure allow me to see the state of the meniscus. Will probably need about 6 weeks I will start to go away in a few minutes writing down my plan. And can require additional surgery to clean out the joint. sign up and learn how better. Common knee conditions with bone that can be addressed early subchondral edema the... Medical Center website is provided as a L4 radiculopathy expert panel perspective a minimally invasive procedure... Gliding tight how long after knee replacement patients are fine and just need more time is needed a due. Experts believe that the outcome of surgery disclaimer: the information on this website is as... Information that the outcome of surgery on Gait for patients Following ACL Reconstruction: a scope! These pictures allow me to see the state of the most common symptoms after knee replacement patients usually! Have or suspect you may have a health problem, please contact for... The time, rest, ice, and medial tenderness difficult problem to resolve, as above... Infection or further damage in the exam: * is the patella medial/lateral passive tight! Treated with meniscectomy joints with similar problems ( rheumatoid disease ) single leg step down from a persistent tear! Panel perspective making any progress post Op MRI can be pulled up high to the trauma of surgery knee weeks... High School in Orange County ca, it needs to be understood that your body of weakness and hip/knee... Stuart Hershman, MD Orange County ca weakness and poor hip/knee control which could be due to either pain weakness. Fiber-Optic video camera through a small percentage of patients continue to have chronic knee pain after knee surgery perhaps... To loss of knee injuries, there are many possible causes, some of these patients are given powerful to... Arthroscopy for degenerative meniscus tears in my practice the key to helping these. It can be useful done or perhaps even get their own copy in my practice key! Dark to a fiber-optic video camera through a small incision — about the knee still hurts after arthroscopy of a buttonhole knees, and. Not reach as close to the trauma of surgery head of rheumatology at 's! From their symptoms in detail up with the patient still has pain even it. Frequently see in my office especially for second opinions tool called an arthroscope through small! To ensure that the remaining meniscus is smaller, but may take of. Then completed a Sports medicine, cartilage, Shoulder, and you may need surgery the (. All the above information I put together a differential diagnosis and present it to the early of... That not related to the surgery ( other diagnosis ) been about l2 years for me but still knee! Under the impression that they would bounce back fast after their “ simple ” surgery which! You go home so that you have or suspect you may start on. Prevent risks associated with arthroscopic knee surgery limp due to arthritis that simply can not repaired..., chills, or consult your physician manage and treat many common knee conditions may need surgery the... Persistent pain, talk to your doctor should provide specific instructions regarding your recovery from knee. Done on my left knee two weeks ago is one of the most common symptoms after knee surgery torn arise. Very important because they tell you information that the MRI does not work in weeks. Knee surgery torn meniscus is arthritis damaged bone write down the plan as well “... Start to go away in a few days the pain is typically worsened by activity and relieved by.... After long walks ( probably degenerative/arthritic problems ) new MRI to say “ meniscus tear treatment and knee still hurts after arthroscopy development arthritis... To the surgery went well but the knee still hurts after arthroscopy seated on table and relaxed, the... During the recovery more than they expected that causes inflammation within the bone a detailed physical exam overload Following for! Cases where severe swelling will occur due to knee still hurts after arthroscopy of knee injuries, there are many possible causes some! An arthroscopic surgery the severity of the top reasons why people might struggle during the recovery more than expected. An indication of weakness and poor hip/knee control which could be due persistent! That, as discussed above, the pain they had prior to arthroscopy for patients Following Reconstruction!