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Causes of Aseptic Persistent Pain after Total Knee Arthroplasty
BACKGROUND: Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS: Of the total 2,534 cases of primary TKA reviewed...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Orthopaedic Association
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334027/ https://www.ncbi.nlm.nih.gov/pubmed/28261427 http://dx.doi.org/10.4055/cios.2017.9.1.50 |
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author | Lim, Hong-An Song, Eun-Kyoo Seon, Jong-Keun Park, Kyung-Soon Shin, Young-Joo Yang, Hong-Yeol |
author_facet | Lim, Hong-An Song, Eun-Kyoo Seon, Jong-Keun Park, Kyung-Soon Shin, Young-Joo Yang, Hong-Yeol |
author_sort | Lim, Hong-An |
collection | PubMed |
description | BACKGROUND: Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS: Of the total 2,534 cases of primary TKA reviewed, 178 cases were classified as having aseptic persistent pain that was not resolved within 1 year after surgery. Except for the cases with periprosthetic fracture (56 knees), 122 cases of aseptic painful TKA were divided into two groups: intra-articular group (83 knees) and extra-articular group (39 knees). RESULTS: In the intra-articular group, the main reasons for pain were aseptic loosening (n = 40), polyethylene wear (n = 16), instability (n = 10), recurrent hemarthrosis (n = 5), patellar maltracking (n = 4), tendon ruptures (n = 4), and stiffness (n = 2). In the extraarticular group, 10 knees (25.6%) were found to have nerve entrapment in the spine, 6 knees (15.4%) were found to have hip osteoarthritis or femoral head avascular necrosis. The reasons for persistent knee pain in the remaining 23 knees (59.0%) still remain elusive. CONCLUSIONS: Persistent pain after TKA originated from pathology of extra-articular origin in a considerable number of cases in this study. Therefore, it is important to perform thorough preoperative evaluations to reduce pain resulting from extra-articular causes. Furthermore, meticulous surgical procedures and optimal alignment are required to reduce pain of intra-articular origin related to implant wear, instability, and patellar maltracking. |
format | Online Article Text |
id | pubmed-5334027 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-53340272017-03-03 Causes of Aseptic Persistent Pain after Total Knee Arthroplasty Lim, Hong-An Song, Eun-Kyoo Seon, Jong-Keun Park, Kyung-Soon Shin, Young-Joo Yang, Hong-Yeol Clin Orthop Surg Original Article BACKGROUND: Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS: Of the total 2,534 cases of primary TKA reviewed, 178 cases were classified as having aseptic persistent pain that was not resolved within 1 year after surgery. Except for the cases with periprosthetic fracture (56 knees), 122 cases of aseptic painful TKA were divided into two groups: intra-articular group (83 knees) and extra-articular group (39 knees). RESULTS: In the intra-articular group, the main reasons for pain were aseptic loosening (n = 40), polyethylene wear (n = 16), instability (n = 10), recurrent hemarthrosis (n = 5), patellar maltracking (n = 4), tendon ruptures (n = 4), and stiffness (n = 2). In the extraarticular group, 10 knees (25.6%) were found to have nerve entrapment in the spine, 6 knees (15.4%) were found to have hip osteoarthritis or femoral head avascular necrosis. The reasons for persistent knee pain in the remaining 23 knees (59.0%) still remain elusive. CONCLUSIONS: Persistent pain after TKA originated from pathology of extra-articular origin in a considerable number of cases in this study. Therefore, it is important to perform thorough preoperative evaluations to reduce pain resulting from extra-articular causes. Furthermore, meticulous surgical procedures and optimal alignment are required to reduce pain of intra-articular origin related to implant wear, instability, and patellar maltracking. The Korean Orthopaedic Association 2017-03 2017-02-13 /pmc/articles/PMC5334027/ /pubmed/28261427 http://dx.doi.org/10.4055/cios.2017.9.1.50 Text en Copyright © 2017 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lim, Hong-An Song, Eun-Kyoo Seon, Jong-Keun Park, Kyung-Soon Shin, Young-Joo Yang, Hong-Yeol Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title | Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title_full | Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title_fullStr | Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title_full_unstemmed | Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title_short | Causes of Aseptic Persistent Pain after Total Knee Arthroplasty |
title_sort | causes of aseptic persistent pain after total knee arthroplasty |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334027/ https://www.ncbi.nlm.nih.gov/pubmed/28261427 http://dx.doi.org/10.4055/cios.2017.9.1.50 |
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