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burning pain after knee replacement

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I seem to be the only person I know that still have pain after tkr. the skin on the right side of the knee is tender to the touch. I am still taking pain meds the tkr was done in 2003. I went to another ortho. Dr. he went back into the knee in 2006 from there I am now on disablility and STILL ON PAIN MEDS.
Am I really the only person that has this problem.
MrsHDNX3
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replied May 4th, 2010
Community Volunteer
My husband had two total knee replacements and I have never heard of this happening that you speak about....Makes me wonder if some nerve was cut or a shot given you that hit a part of your knee that remains alive...I know that after I had my Hysterectomy when I was 47 years old, that they hit a nerve in my buttocks when they put it in...I screamed in pain and swore that they left the needle inside me...It took a long time for me to get over this hurt...I can recall when my husband had his that after the surgery they have you connected to a blood machine to circulate the blood...This is at the side of your knee....I know as I just about flipped out when I came in to see him for the first time...The machine was going and pumping blood and it was a big hose that was attached to the inside of the knee at the replacement...It is possible that some injury happened when this happened...I know I was there the day they pulled it out and that was very painful...Each of us has a different reaction to a surgery...What is OK for one may not be the right thing with the other...Just simple handling when you are operated on can cause pain....I wish you well...Take care...

Caroline
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replied April 1st, 2011
tkr replacement pain
You are not alone. I had a tkr in 2003, in 2007 the tibia came loose and had to be replaced, in 2009, the the replaced tibia became de-bonded at the prosthesis. They removed everything and did another tkr. In 2010, I started having issues of a minor type, however, now they have increased and I have a burning sensation in the front of my knee and I get horrible pain on the front and sides which does not allow me to walk any distance without pain killers. I'm going to a specialist in August because no one in my hometown can seem to figure out anything.
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replied June 4th, 2011
Pain several months after total arthroplasty
I had a right knee total arthroplasty done August 2010, and the left knee done December 2010. I now am experiencing burning on the right side of the patella on the right knee. I am trying to see if there are known allergies to titanium?!?! I cannot seem to find an answer anywhere.
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replied June 4th, 2011
Pain several months after total arthroplasty
I had a right knee total arthroplasty done August 2010, and the left knee done December 2010. I now am experiencing burning on the right side of the patella on the right knee. I am trying to see if there are known allergies to titanium?!?! I cannot seem to find an answer anywhere.
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replied July 31st, 2011
I had total left knee replacement in october of 11 and in march of this year my knee started to burn....burn and burn more. Had local dr take xrays and it showed everything to be normal or so he said. Interesting when I went to get my records to take to dr that did replacement all of the same records disapeared. Have an appointment when dr that did surgery have a several hour drive since we moved from area. I have no clue what this is thinking nearve damage? something did not heal right? the burning pain has stopped me from walking other than just what I have to do nothing more. It is not you , I have the same issues and pain daily only rest I have is sleeping. Good luck to you and keep me posted as to your treatment plan and your healing.
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replied June 4th, 2011
Especially eHealthy
Deb,

Titanium allergy is extremely rare. It has been noted mostly in titanium jewelry, especially body piercings. Allergies to nickel are a lot more common. The symptoms are usually the same as that of other allergies. For jewelry, it tends to be a contact type of allergy, with irritation of the skin in contact with the metal. Systemic systems include rash and signs of anaphaylaxis.

Pain in a small localized area around an internal prosthesis would probably not be consistent with an allergy. A contact allergy would cause the whole knee to be extremely inflamed, red, and swollen. A systemic allergy would have a rash most likely and, of course, anaphaylaxis would have shown up within a few hours to days after implantation.

The most common cause of localized area of tenderness around the joint line is irritation of the surrounding support structures by the prosthesis. Sometimes the prosthesis overhangs the tibial plateau some, where the soft tissue can rub on it.

Maltracking of the patella can also cause irritation of the fascia holding the patella in line.

On the other side of the patella (the medial side), there is a nerve that can get irritated. Doesn't usually happen on the lateral side, but it's possible.

Have you discussed the problem with your joint surgeon? He/she is in the best position to determine what is going on. He/she put the joint in, so he/she knows what the knee looks like on the inside.

I'm not sure where you were looking for information, but if you google "titanium allergy", you will come up with several sites about it. Several, however, are sites trying to sell you testing kits, just beware of some of these sites. Also, some have very skewed opinions, they are sort of an missions "to get the word out". Just come to your own conclusions.

Good luck.
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replied July 31st, 2011
burning knee after total knee replacement
Burning in left knee after total replacement in october 11 started in march. Going back to dr that and see what he has to say. Burning is a catch 22 can not move too much I ice, take pain medication, knee remains swollen, only rest of Have is sleeping on one side. Not sure I can take another knee replacement or trust the dr that did this again. Will also add had right knee replacement in june of 11 and now just recently this knee burns at times also not nearly as bad as the left.
Any feedback, medications, treatments etc would be so appreciated. Feeling defeated.
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replied July 31st, 2011
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nutmegandme,

It is indeed unusual for a total joint replacement to be doing okay, then at five months post-op start developing pain (the left one - done in October, I assume in 2010). The right one, done in June 2011, is still in the immediate post-op period.

You do not say where the burning pain is located. Often, pain described as burning is from a nerve. Sometimes, when doing the skin incision for a total knee, a peripheral skin nerve gets transected, and it can then develop a neuroma. But, this pain is only in the area supplied by the nerve.

Though it is a little late, another nerve problem that one has to be concerned about, when a patient has unexpected pain that lasts longer than normal, can be burning in nature, associated with swelling is Complex Regional Pain Syndrome Type I (formerly called Reflex Sympathetic Dystrophy - RSD).

Other concerns for pain after a total joint, is an indolent infection. Especially with the persistent swelling.

Another problem, is aseptic loosing of the components. But, it is actually a little early for this problem, as it usually shows up several years after a successful surgery, as the prosthesis is wearing out. But, I guess it is possible, after just 5 months.

Arthrofibrosis of the joint can be associated with persistent swelling and pain. This will often present in a delayed fashion, where the patient is doing okay immediately post-op, but then just stops making progress in rehab. The joint starts to develop woody edema and losing range of motion. Then the patient has pain trying to move it.


These are just a few possible etiologies for a persistently painful total joint. This can be a very difficult problem to ferret out, and very frustrating for the patient and surgeon alike.

It may take quite a bit of effort to determine what is causing the pain. During the work up, sometimes selective injections with local anesthetic are used. If these help, then it is usually a nerve problem. If it is determined to be a nerve problem, a couple of medicines that are sometimes used are gabapentin (Neurontin) and pregabalin (Lyrica).

If an infection is discovered, then you may need antibiotics and/or surgery.

But, until you see the surgeon again, keep notes of when the pain is the worst, what causes it, what makes it better, is it worse in the morning or after activity, do you have any associated symptoms, and anything else you feel may be important.


Hope you discover what is causing the problem. Good luck.
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replied September 9th, 2012
I just recently had my Right knee replaced. Spent two weeks in hospital, was unable to take the pain medication. My recovery is slow. Since the surgery, I have had this burning sensation above my knee over the whole top of my leg to my hip. they said it was nerves and would disappear in a couple of weeks. they gve me Noritripiline for the pain. I have yet to notice a difference. I continue to have problems bending my knee and the pain around knee is unending. My leg is warm to the touch. Im beginning to think I should of kept my old knee, the pain was bad, but this is inabearable
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replied September 9th, 2012
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Bvann,

It is not uncommon for patients to develop a burning pain in the upper thigh after a total knee replacement (or other knee surgery). This is usually due to pressure on the nerves from the tourniquet which is used during the surgery. And, as the surgeon stated, the neuropraxia usually resolves on its own. But, how long it takes varies among patients (some take up to six months or longer to resolve). If the Nortripyline is not working, you might inquire about one of the other nerve pain medications (gabapentin or pregabalin).

It is unfortunate that you had problems with the opioid pain medication. It is also unfortunate that you did not have an epidural done, so that you could start your therapy. The therapy is so important to the outcome, and is about 80 to 90% of the success of the procedure.

However, you do not say how long ago you had your TKR done. If it has been several months and you continue to have warmth, pain, decreased motion, swelling, etc, you might want to see your surgeon again. It may be that you are developing CRPS I (Chronic Regional Pain Syndrome, Type I - which used to be called RSD or Reflex Sympathetic Dystrophy).

This is not to say that you are. It is not uncommon to have warmth around the surgical area for many months (even up to a year or more). And, many patients have problems with therapy and regaining motion. But, the constellation of symptoms you describe should be evaluated. If it is CRPS I, then early diagnosis is the key aspect to a successful outcome.

Sorry that you are having so many problems with your replacement.

Good luck.
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replied October 27th, 2012
Hi Bvann. I had a total knee replaced in March of this year and am due to have the other one done in December. There was quite a lot of pain after the op and a lot of debilitation which made me say that I wouldn't have the other one done but it eased and I'm glad I had it done.I am hopeful that the other one will be as good. The worst thing I found was not being able to go to work for 6 weeks. I couldn't go out either unless someone was with me as I couldn't carry anything because of the stick/s.Stick with I'm sure you'll be glad probably by the time you read this. Maureen.
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replied September 12th, 2011
knee replacement pain
my knee burns if i try to bend when walking. outer aspect of knee I can bend for the exercises but not when walking, it burns so much . Is there a possible pinched nerve that catches on the walk bend? I have an EMG booked for Nov to see if a nerve is in fact involved, but cannot walk for any distance or time after almost 4 months post op. therapy 3x a week, massage therapy 1x a week, no relief. Any answers for me?
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replied August 9th, 2012
Burning after total knee arthoplasty
Hi I had a total knee arthoplasty which was rather blotched I have burning right after surgery was told its normal as the little shocks I got right after it felt like im getting electrical shocks. now it burns and burns and the pain is more then before the surgery i wish I never had it done. Im rather young but needed it as i was at the endstage of arthitis, i ice it constantly and pain meds wont help i;m on really strong ones and nothing works I;m up for days and then crash for days crying myself to sleep i push myself at therapy . the surgeon i saw is rather untouched as soon he got pain. at times i wish i could take the darn thing off as they had originally thought off. has anyone had any relief since posting thank you
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replied August 9th, 2012
Burning after total knee arthoplasty
Hi I had a total knee arthoplasty which was rather blotched I have burning right after surgery was told its normal as the little shocks I got right after it felt like im getting electrical shocks. now it burns and burns and the pain is more then before the surgery i wish I never had it done. Im rather young but needed it as i was at the endstage of arthitis, i ice it constantly and pain meds wont help i;m on really strong ones and nothing works I;m up for days and then crash for days crying myself to sleep i push myself at therapy . the surgeon i saw is rather untouched as soon he got pain. at times i wish i could take the darn thing off as they had originally thought off. has anyone had any relief since posting thank you
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replied August 9th, 2012
Especially eHealthy
sophias_pain77,

Is the pain exactly the same as before the surgery, or has it changed in character? Pain which is "burning" in nature, truly burning, is thought to be nerve in origin. Many patients will describe any significant pain as burning, but truly burning pain is almost always caused by a nerve disorder.

But, nerve pain will be in a very specific distribution, in the area supplied by the nerve. It will not be a generalized or overall pain.

So, the characteristics of the pain are very important, as is where exactly the pain is located. Other things, such as what makes the pain worse (or better), when the pain seems to be the worst (or least), are there other symptoms that go along with the discomfort, etc have to be assessed, to determine where the pain is coming from.


If your surgeon does not want to evaluate your pain, then ask your primary care provider to refer you to a pain management physician.

While waiting to see your surgeon or a pain management physician, keep a pain journal. List what your pain is like when you get up, after activity, at bed time, etc. Record what you do for your pain. Put down anything else you think is relevant.

Use a 0-10 pain scale. Remember, that 10 is not the worst pain YOU have ever had, but the worst pain ever imaginable (such as being boiled alive in hot oil). And be honest with yourself on the scale. Do not exaggerate, that is the fastest way to make a physician think of you as hysterical.


Good luck. Hope you finally get a handle on your pain.
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replied September 11th, 2012
Thank-you for your reply, my surgery was two weeks ago, and just found out I will be getting therapy at home. I was told to take Tylenol 3s for the pain. these don't even help my headache. The thought of having this for months is very upsetting. re: nerve pain
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replied September 11th, 2012
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Bvann,

Most neuropraxias that develop from the tourniquet resovle within a maximum of six weeks. But, a few take longer.

You are still within the very early post-op period, so the surgeon may not want to put you on any of the big nerve pain medications (they are good, but do carry some risks with them), since most times this problem is shortly self limiting.

As to the headaches, they can actually be caused by the opioid pain medication. And, some people get "rebound" headaches when they stop opioids.

If your headaches continue, they should be evaluated though.

Good luck with your rehab. Hang in there, you still have quite a ways to go before you know what your final outcome is going to be.
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replied October 26th, 2012
Pain and burning after knee replacement.
I am having pain ever since I had total knee replacement in 2009 and am very sorry I did it. The knee looks disgusted swollen warm to the touch and I had a huge bliSter on e
Right side of knee after surgery which is scarred Snd extremely tender to touch. I cannot kneel bend it or walk easily. My dr says its scar tissue biut an R N told me just recently that it looks like a burn from the laser which makes more sense than anything I've been told to date. I am not against replacement for most people. It just didn't work for me. If anyone else had this problem I'd love to hear from you
Thanks. Jo Ann f
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replied October 26th, 2012
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joann29,

Sorry about your continuing problems. It is a shame that you are having problems after a surgery that usually makes patients so much better.

As to the discussion about this being from a “laser”, there are no lasers used in total joint surgery. (There are some laser type of instruments, along with radiofrequency wands, that are used to “shrink stretched tissues” like on the inside the shoulder joint. But, these are not used in total joint procedures.) However, most surgeons do use electrocautery. This is a small instrument which uses electricity to heat the tip, so that it can be used to cauterize small blood vessels, as the soft tissue dissection is done. It is also often used to cut through soft tissue, again, to reduce the amount of bleeding. There are some rare cases where the electrocautery has caused burns.

However, the usual cause of blisters around a total knee is from handling of the tissues, causing problems with the blood supply to those tissues. The most common way to do this is to place a retracted on the skin edge, then after the retractor has been under pull for quite a while (to open up the surgical site so the surgeon can see deep into the wound), the blood supply to the skin under the retractor is basically lost. This can result in the formation of a large blister like wound, and then the top layer of skin sloughs off. Another way this can occur, is from massive swelling within the joint after surgery (which is why most surgeons place drains for a little while), which actually causes shearing of the layers of the skin, resulting in large blisters. (This can also be seen after fractures, where is it called a “fracture blister”.)


But, whatever the cause was, if you are continuing to have a lot of problems with that patch of skin, you might want to see a plastic surgeon. There may be something that can be done with it, to make you more comfortable and better able to use the joint.

Wishing you the best. Good luck.
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replied December 25th, 2012
I had a TLKR in Oct 2012. I have had a Swollen foot and ankle since 2/3 weeks after the operation with awful pains in my foot. Also a sensation which ,nearly drives me crazy, I can only describe this as like walking on grit. I still cannot get shoes on. Also get burning around the wound.
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replied December 25th, 2012
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Cleo1,

If you have not discussed this with your surgeon, and have had him/her take a look at your left lower extremity, you probably should.


You do need to get the swelling under control, as that will help quite a bit with your symptoms. We usually recommend that our total knee patients continue to wear a thigh high compression stocking until their swelling is under good control. This may take a few weeks.

Ice and elevation will also help reduce the swelling, as will movement of the foot and ankle. Edema and venous blood require muscle action to pump them out of the lower extremities and back into the body core. So, ankle circles and calf pumps will help reduce the edema and swelling.

But, again, it sounds like you need to get some good circumferential compression on the limb. This is best accomplished with commercial compression hose/stockings, such as are used in the hospital (like TED hose). They need to be above the knee, all the way from the toes to the groin.

These compression stockings will help tremendously with your swelling.


You can also have someone massage the limb, starting at the toes, and moving up the foot and leg. This will again, help to push the retained fluid back towards the body.

Also, again, ice (or heat if you prefer) and elevation above the heart level, will help to get the fluid back into the body and out of the lower extremity.


Just reducing your retained edema and fluid should help a lot with your symptoms. The fluid could be putting pressure on the nerve of the lower extremity.


However, if the reduction in swelling and some time do not take care of your symptoms, you really need to speak with your surgeon about your burning pain. This could be nerve pain, and there are some medicines which might help. These are gabapentin (Neurontin) and pregabalin (Lyrica). They are not opioids and are non-narcotic.

Good luck.
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replied April 11th, 2013
Google "Melisa" or find it after googling titanium allergy. This is a world-renowned lab - the best testing you can get. You can definitely be allergic to titanium.
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replied June 18th, 2013
TKR
My mother had bilateral TKR three years ago. No physical therapy prior to surgery and she hadn't bent those knees in years. Poor PT after. She is now 81 years old and has constant burning pain. Radiates up the knee and into the hip. Surgeon just says "well, your knees surgery was successful". What a load of BS. I suspect he did a crap job and severe nerve damage. Keeps her up at night and meds have not worked.
I would advise against TKR for most people. Especially a bilateral at 78 years old. But $$ certainly talks. He got paid. She got worse pain.
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replied June 20th, 2013
Total Knee Replacement
Hi had TKP 4months ago, I'm 46 , had to have implants put in below knee and above, all from a bad injury when I was younger, everything went fine during op, had to get blood transfusion after, but everything went well, kept up exercises etec, now it feels as if sometimes the knee is going to pop out or lock, dont take painkillers as not a great fan of them and pain is only for a short while, just wondered is it normal to have the sensation that the joint feels as if it could lock or pop out,? pain is bearable, appreciate any help.
many thanks
jon
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replied June 20th, 2013
Hi had TKP 4months ago, I'm 46 , had to have implants put in below knee and above, all from a bad injury when I was younger, everything went fine during op, had to get blood transfusion after, but everything went well, kept up exercises etec, now it feels as if sometimes the knee is going to pop out or lock, dont take painkillers as not a great fan of them and pain is only for a short while, just wondered is it normal to have the sensation that the joint feels as if it could lock or pop out,? pain is bearable, appreciate any help.
many thanks
jon
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replied June 21st, 2013
To all those in the above comments about problems with knee replacements. You are all describing the varying symptoms (not everyone experiences exactly the same symptoms) of allergy to titanium or whatever other metal is implanted in your body. You can have your blood tested at a MELISA lab (google it) and find out quickly whether you are allergic to the metals used in your knee replacements. The people there are more than helpful and will answer any and all questions you have. If you test positive for the titanium or other metal, your only option is to remove the offending prosthetic joint and replacing it with something you are not allergic to. MELISA can help you there too. There are many stories like yours, and these people get total relief after the substance is removed.
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replied June 21st, 2013
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Jon,

No, it is not "normal" for a total knee replacement to feel this way. However, some patients can develop problems with tracking of the patella (kneecap), which can "catch", giving a feeling of the knee "locking" up.

Some patients also develop a condition, where some scar tissue forms around the joint. This scar tissue can get caught in the joint, again, giving a feeling of the joint wanting to lock or pop.


Make sure that you are continuing to build you strength back up in the muscles around the knee. If you are like most people, you probably were not doing a whole lot of activity before your knee surgery, so you probably became pretty weak. Then, the muscles atrophy even more right after the procedure. All of this loss of muscle mass and strength has to be rebuilt.

If you still have weak quadriceps muscles (the muscles in the front of the thigh), that can cause problems with the knee wanting to "give way". The quads are the main postural muscles, keeping the patient upright. Again, with weak quads, the knee will continually give way (even to the point of the patient falling down).


If you have done all of your rehab, yet continue to have problems with your new knee, see your surgeon for an evaluation.


Good luck.
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replied September 14th, 2013
TKR 3 weeks out
Gaelic,

Thank you for your presence on this blog. It is very refreshing to see someone, who is qualified to make statements, do so without concern of the need to express a disclaimer.

Thanks!
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