Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Lim, Hong-An, Song, Eun-Kyoo, Seon, Jong-Keun, Park, Kyung-Soon, Shin, Young-Joo, Yang, Hong-Yeol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2017
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
_version_ 1782511806923669504
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
work_keys_str_mv AT limhongan causesofasepticpersistentpainaftertotalkneearthroplasty
AT songeunkyoo causesofasepticpersistentpainaftertotalkneearthroplasty
AT seonjongkeun causesofasepticpersistentpainaftertotalkneearthroplasty
AT parkkyungsoon causesofasepticpersistentpainaftertotalkneearthroplasty
AT shinyoungjoo causesofasepticpersistentpainaftertotalkneearthroplasty
AT yanghongyeol causesofasepticpersistentpainaftertotalkneearthroplasty