Evaluation of Painful Knee

Knee replacement surgery is one of the most successful treatments for severely damaged joints, but a minority of patients may experience problems. If you're in pain following knee replacement surgery, the expert team at Gardner Orthopedics in Fort Myers, Florida, can help. They perform a comprehensive evaluation of painful knee replacements to help you find relief from your discomfort. Gardner Orthopedics receives patients from Lee, Collier, Hendry, Charlotte, Sarasota, Manatee, Hillsborough, Glades, Desoto, Pinellas, and Monroe counties. For compassionate care of your painful knee replacement, call their office or book an appointment online today.

Evaluation of Painful Knee Replacements & Metal Sensitivity

You may need an evaluation of painful knee replacements if you're having problems after knee replacement surgery.

Knee replacement is the most common type of joint replacement surgery. It offers relief of pain and improved mobility for those who suffer from conditions like severe osteoarthritis.

Following surgery and rehabilitation, the majority of patients have a successful outcome. However, for some, knee replacement can cause chronic pain.

There are several potential causes for painful knee replacements, including:

Implant loosening

The knee replacement parts may become loose, leading to persistent pain. This loosening often occurs after you've had the implant for a long time – years or even decades.

Implant "rejection"

BY FAR the most common example of this is from nickel sensitivity and metal sensitivities are THE MOST COMMONLY missed cause for painful knee replacements though they may account for over 50% of the ones that are not infected. We are always thinking about this and test for it. Even that problem can usually be resolved. (It is surprising how many people can’t wear costume jewelry, for instance, and it never comes up prior to having their knee replaced and then the knee replacement recovery doesn’t go well. In our office we actually ask about that prior to surgery and if there is doubt we use a ceramic bonded implant).


This can be ruled in or out with specialized X-ray, radiologic scans, or lab tests.

Patellofemoral (kneecap) problems

You may have less than perfect kneecap function following knee replacement surgery, as your kneecap has to bear a significant strain.

Alignment issues

If the alignment of your implant isn't quite right, it can put pressure on the joints, nerves, and other tissues, resulting in pain.

An infection or fracture in the remaining bone could also cause painful knee replacements.

Other causes

As an example, it is possible to have ONLY KNEE pain with hip osteoarthritis. We check for remote (so called “referred") causes of the pain.

To evaluate your painful knee replacement, the team at Gardner Orthopedics begins by discussing your problems with you and finding out about the nature of the pain. Some issues could improve without intervention; for example, startup pain (when you get up from a sitting position) might pass in a few months.

Other symptoms could indicate a more serious problem. Pain when using stairs or visible kneecap deformity is likely to be a patellofemoral issue, while startup pain that fails to improve suggests you have a loose implant.

The next step in the evaluation of painful knee replacements is a physical examination. Your provider at Gardner Orthopedics assesses your knee mechanics and alignment and checks for signs of stiffness and infection. 

You may need to undergo diagnostic tests, such as X-rays, a bone scan, an MRI scan, or arthrocentesis (joint fluid aspiration).

Your required treatment after your painful knee replacement evaluation depends on what's causing your pain. You may need medication for an infection or benefit from physical therapy. Severe problems might require further surgery called revision knee replacement.

To find out what's causing your symptoms, schedule a painful knee replacement evaluation at Gardner Orthopedics. Call their office or book an appointment online today.

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