Our Protocol

Your surgeon at Personalized Painful Knee Replacement Institute will take several steps to evaluate your pain. The first step simply involves getting to know you and understanding your pain. Pain can have many different qualities, and the type of pain described can help your doctor make an accurate diagnosis.

While pain that’s rising – known as start-up pain – usually resolves within a few months, other types of pain may suggest a more serious condition. In some cases, the location and timing of the pain can help a doctor pinpoint the underlying cause.

Common Diagnostic Signs

These signs can aid your doctor in a diagnosis:

• Persistent start-up pain can be a sign of a loosening implant
• Pain when navigating stairs suggests a kneecap problem
• The sudden appearance of pain suggests a fracture or injury
• Pain accompanied by swelling, redness, and fever are strong indications of an infection
• A deformed kneecap is a sign of a patellofemoral problem

We will also examine the knee. A physical exam can help identify infection, stiffness, and alignment issues. Ensuring that the mechanics of the knee replacement are sound is important. Just like having the proper alignment in your car, it is important that the knee replacement is properly aligned and balanced.

Imaging

X-rays and other studies can assess alignment and loosening. Subtle loosening may not show up on a regular ​X-ray, and a bone scan or magnetic resonance imaging (MRI) scan may be performed. In addition, there are specialty imaging studies that can be performed specifically to assess for problems related to the knee replacement.

X-rays performed fluoroscopically (in real-time) and stress radiographs to evaluate ligaments are sometimes performed. MRI is better suited for soft tissue injuries and can be particularly useful if there is infection or inflammation related to bursitis or tendonitis.

Lab Tests

Laboratory studies that are sometimes performed include markers of inflammation such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) tests. Elevations of these markers of inflammation can indicate an infection or other inflammatory medical conditions.

One of the most commonly performed procedures for a painful knee replacement is arthrocentesis (joint aspiration). This involves the insertion of a needle into the knee joint to obtain some fluid from around the implant.

The fluid, called synovial fluid, can be analyzed in the lab to look for signs of infection or abnormal crystallization around the knee joint. Tests commonly performed on synovial fluid include a white blood cell count (WBC), bacterial gram stain, and bacterial cultures.

According to a 2012 study from France, infection occurs in between 1% - 3% of knee replacement surgeries and is the leading cause of knee revision surgery.

Find out why the care you get at Personalized Painful Knee Replacement Institute in Boynton Beach, Florida, is unlike any other. Call us at (561) 903-7448 for freedom from lingering post-op knee pain. You can also request your appointment now.