What Causes Knee Pain And Stiffness Post A Knee Replacement Surgery?

Posted on Fri, 6 Oct 2017

Question: Hi, I am a 73 yo Caucasian man in generally good health and a regular swimmer, cyclist and walker. I had a total right knee replacement on 5/25/2016, so I am about 16 months post-op. My PT was a little behind standard but I achieved my doctor's goals with extra sessions and an extra 2 weeks. I resumed swimming at 5 weeks post-op, and cycling gently at about 4 Months post-op. My knee functions well.My recovery was slow, but at about 12 months post-op, pain and stiffness had reduced considerably and pain was rare and generally moderate. On a vacation trip, beginning over one month ago, I resumed cycling in the mountains at a moderate altitude of 6000 to 8000 ft, with steady steep climbs and saw improvements in strength and fitness but my knee was increasingly sore. I took recovery days, and resumed when knee felt better. I had 2 hard sessions followed by a moderate day on Sept 6. Since then , for seven days, knee is exceptionally sore, with an achy pain at a constant 2, with some periods of pain approaching 9, some nights I am unable to sleep due to pain. Pain is lessened by 800 mg ibuprofen. Pain is located from 3" above knee to 5" below knee and is most sore on the lateral side (where I understand the IT band attaches) and only occasionally radiates down to my shin. There is a distinct hot zone around this IT band attachment point, varying from warm to hot. Swelling is greatest at the knee but appears to extend to both thigh and calf. There is no discoloration.
We are temporarily displaced due to hurricane XXXXXXX & I am attempting to get an appointment for an exam and consultation at a local orthopedic office and have been delayed by difficulty in obtaining records from my SW Florida physician. I am planning on asking these questions. 1) is the artificial knee displaced or possibly moving? 2) Could I have an infection? 3) could this be compartment syndrome caused by exceptional excercise including extension under pressure?
My questions to you are A) what conditions would you suspect? B) what other questions would you ask? C)
Should I continue icing and elevation until I can be assessed?

Thank you for considering my questions, I am eager for your response... XXXXXXX

Answered by Dr. Dr. Praveen Tayal (4 hours later)

Brief Answer:
Can be due to inflammation related to stress.

Detailed Answer:
Hello,
Thanks for posting your query.
From the symptoms described this seems to be a minor inflammation due to excessive stress on the knee. The knee is not displaced as a displaced knee is unstable and there is no abnormal noise on bending or extending the knee.
Infection is less likely as there is no redness or fever. Compartment syndrome is associated with extreme pain and tightness.
In my opinion the most likely cause of pain and swelling is an inflammation. A direct examination is needed to confirm the diagnosis. You can continue icing ibuprofen and elevation till further assessment. This may take 2-3 weeks to subside. Avoid all painful activities.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar