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Suggest Treatment For Severe Pain And Swelling After Knee Replacement Surgery
Question: I had knee replacement 7 months ago. I still have severe pain and swelling around my knee, calf and lower thigh with any activity. It is a hot shearing pain when I go up and down stairs, and a tearing type pain as I walk. My calf feels as if I have a constant XXXXXXX horse and my thigh cramps or spasms with nearly every step. My Dr. wants to give me Euflexxa injections. My PT says he has never heard of giving this type of injections after surgery, only before. I was told Euflexxa is a lubricant. Why would an artificial knee need lubricating? Will it help my type pain? I also have a large Baker's cyst behind my knee that is quite uncomfortable. I was told it was a build up of excess fluid due to my arthritis before surgery. Will the injections cause more fluid to build up in the cyst?
Brief Answer:
Uni or bi compartmental knee replacement
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem.
Have you had a knee replacement to both your condyles, or is it only unicompartmental replacement ?
It would be very helpful, if you could upload the Xray, Xray report or Hospital report for me to be in a better position to help you.
If you have had replacement only to your medial compartment, then the lateral compartment could have now developed arthritis. Otherwise there is very less chance for arthritis to occur in a knee with bi-compartmental arthritis.
Osteoarthritis affects the knees in older age group persons, gets worse on climbing up or down stairs, squatting, cross leg sitting or kneeling.
Due to the arthritis, the muscles around the knee as of those of the thigh and leg tend to cramp up, as a protective reflex to limit the activity of the arthritic knee.
Also you have a Baker's cyst behind your knee, which is seen mostly in Osteoarthritic knees.
I would like to give you some suggestions -
(1) Apply hot water bottle or warm packs to the areas of pain as this relieves muscle spasm and gives a lot of relief.
(2) Keep the limb elevated as this helps to drain away muscle swelling around the knee and offer relief.
(3) Avoid cross leg sitting, squatting, kneeling. Try to minimise stair climbing.
(4) Apply knee caps for relief from the pain.
(5) You can use walking aids like walking stick to help get around and avoid much weight bearing on the arthritic knee.
If you are having hot shearing pain only since recently, then the Baker's cyst may have burst and the fluid of the cyst has accumulated in your leg, which can cause severe pain in the leg.
I advise you to follow these precautions and also consult your Doctor about ruptured Baker's cyst if you have a recent worsening of the pain.
Euflexxa is not a lubricant alone, but also helps stimulate the regeneration of the damaged knee cartilage in knee arthritis. With this injection and proper precautions your pain can be controlled well. If your patella hasn't been replaced, it could be the reason it's cartilage damage could be causing the pain as well.
Once the arthritis gets better, the Baker's cyst could subside and get smaller. Also if the cyst is causing problems due to it's size, it must be removed surgically for better relief.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Uni or bi compartmental knee replacement
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem.
Have you had a knee replacement to both your condyles, or is it only unicompartmental replacement ?
It would be very helpful, if you could upload the Xray, Xray report or Hospital report for me to be in a better position to help you.
If you have had replacement only to your medial compartment, then the lateral compartment could have now developed arthritis. Otherwise there is very less chance for arthritis to occur in a knee with bi-compartmental arthritis.
Osteoarthritis affects the knees in older age group persons, gets worse on climbing up or down stairs, squatting, cross leg sitting or kneeling.
Due to the arthritis, the muscles around the knee as of those of the thigh and leg tend to cramp up, as a protective reflex to limit the activity of the arthritic knee.
Also you have a Baker's cyst behind your knee, which is seen mostly in Osteoarthritic knees.
I would like to give you some suggestions -
(1) Apply hot water bottle or warm packs to the areas of pain as this relieves muscle spasm and gives a lot of relief.
(2) Keep the limb elevated as this helps to drain away muscle swelling around the knee and offer relief.
(3) Avoid cross leg sitting, squatting, kneeling. Try to minimise stair climbing.
(4) Apply knee caps for relief from the pain.
(5) You can use walking aids like walking stick to help get around and avoid much weight bearing on the arthritic knee.
If you are having hot shearing pain only since recently, then the Baker's cyst may have burst and the fluid of the cyst has accumulated in your leg, which can cause severe pain in the leg.
I advise you to follow these precautions and also consult your Doctor about ruptured Baker's cyst if you have a recent worsening of the pain.
Euflexxa is not a lubricant alone, but also helps stimulate the regeneration of the damaged knee cartilage in knee arthritis. With this injection and proper precautions your pain can be controlled well. If your patella hasn't been replaced, it could be the reason it's cartilage damage could be causing the pain as well.
Once the arthritis gets better, the Baker's cyst could subside and get smaller. Also if the cyst is causing problems due to it's size, it must be removed surgically for better relief.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Yogesh D
As I said, I had total knee replacement. There is no knee, it is titanium, which I assume cannot develop arthritis. There is no cartilage! It was removed and replaced by the artificial joint. My arthritis developed from an old injury to my knee. My other knee is free from arthritis. I have done the heat, ice packs, elevation. I am taking Mobic 7.5 mg 2x a day. I have tried M1 cream, but it does not help. My concern is the injections of Euflexxa is the wrong treatment and may make things worse especially my Baker's cyst. It has been checked. It is intact. I had asked if it could be drained since it is large (about 1 1/2 the size of a walnut) The Dr. said they don't do that any more. The technical terms you asked me of the type replacement are foreign to me, you need to express medical language in "laymen terms". I assumed when I said total knee replacement, you would understand I have an artificial joint.
Just clarify to me if Euflexxa injections AFTER total knee replacement is a standard therapy for pain after 7 months of ineffective treatment and therapy.
Just clarify to me if Euflexxa injections AFTER total knee replacement is a standard therapy for pain after 7 months of ineffective treatment and therapy.
Brief Answer:
Euflexxa not standard in TOTAL or BICOMPARTMENTAL Knee replacement
Detailed Answer:
Hi there,
I am sorry if my previous reply was not effective. Let me answer your questions specifically this time.
1. The Baker's cyst needs to be excised or removed surgically . They do not drain the Baker's cyst anymore nowadays.
2. The other possibility is malalignment of the titanium parts of the knee replacement. Besides infection or loosening of the titanium parts can also be the causes. They are common complications of knee replacement resulting in chronic pain.
3. Euflexxa is NOT a right therapy for pain in a case of Baker's cyst, especially when there is total knee replacement. The right therapy is excision of the cyst, especially if it is large. Moreover infection, loosening and malalignment of the components should be ruled out.
I suggest you discuss about other possibilities and about cyst excision with your treating doctor.
I hope I have answered your query.
Thanking you.
Regards,
Dr. Aashish Raghu
Euflexxa not standard in TOTAL or BICOMPARTMENTAL Knee replacement
Detailed Answer:
Hi there,
I am sorry if my previous reply was not effective. Let me answer your questions specifically this time.
1. The Baker's cyst needs to be excised or removed surgically . They do not drain the Baker's cyst anymore nowadays.
2. The other possibility is malalignment of the titanium parts of the knee replacement. Besides infection or loosening of the titanium parts can also be the causes. They are common complications of knee replacement resulting in chronic pain.
3. Euflexxa is NOT a right therapy for pain in a case of Baker's cyst, especially when there is total knee replacement. The right therapy is excision of the cyst, especially if it is large. Moreover infection, loosening and malalignment of the components should be ruled out.
I suggest you discuss about other possibilities and about cyst excision with your treating doctor.
I hope I have answered your query.
Thanking you.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
7-9-15 4:20 pm
Did you get my 3rd follow-up questions?
I have done or asked to be done (baker's cyst removal) everything you have suggested.
Other than testing for infection, there seems to be nothing left to check. Is it possible for my knee components to be loose and not show up on x-Ray?
Please see if you can find my other questions as it was lenghly and I don't remember what all I included.
Thanks XXXXXXX
Did you get my 3rd follow-up questions?
I have done or asked to be done (baker's cyst removal) everything you have suggested.
Other than testing for infection, there seems to be nothing left to check. Is it possible for my knee components to be loose and not show up on x-Ray?
Please see if you can find my other questions as it was lenghly and I don't remember what all I included.
Thanks XXXXXXX
Brief Answer:
Follow up
Detailed Answer:
Hi XXXXXXX
Thanks for the query.
I'm sorry, I have not received your 3rd Follow up. Kindly include what you wish to ask me in your next follow up if you please.
I am pleased that you have asked your Doctor to remove your Baker's cyst. I hope he shall consider it and discuss with you about the surgery.
Knee components being loose can show up on XRay and also presents as problems in walking with pain.
I hope I have answered your query.
I will be available to answer your follow up queries.
Thanking you.
Regards,
Dr. Aashish Raghu
M.S. Orthopaedics
Follow up
Detailed Answer:
Hi XXXXXXX
Thanks for the query.
I'm sorry, I have not received your 3rd Follow up. Kindly include what you wish to ask me in your next follow up if you please.
I am pleased that you have asked your Doctor to remove your Baker's cyst. I hope he shall consider it and discuss with you about the surgery.
Knee components being loose can show up on XRay and also presents as problems in walking with pain.
I hope I have answered your query.
I will be available to answer your follow up queries.
Thanking you.
Regards,
Dr. Aashish Raghu
M.S. Orthopaedics
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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