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Why do I have knee pain after surgery?

Wednesday, 24 June 2009
Answered by: Dr Pankaj Kaw
Consultant, Orthopaedics and Sports Medicine, Thomas Jefferson University,USA
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Q. I am a 53 years old man who had an arthroscopic knee surgery 5 months back to relieve a torn meniscus. It was the medial collateral ligament (MCL) injury. I did physical therapy too. Why does it still hurt so badly? It especially hurts inside the knee where one of the holes was made. I walk daily and my work demands me to stand since I am a hairstylist. It hurts worse now than before surgery. I used to run and do all sorts of physical activity earlier. Now when I do, I am in pain for many days. Please advise.

A.  My guess is that you had a degenerative torn medical meniscus (not a traumatic one, which we see in younger folks) associated with Knee osteoarthritis.

If the torn degenerative meniscus is not causing any mechanical symptoms (locking, etc) the treatment usually is non-surgical with includes painkillers, Cortisone injection, viscosupplement injections (synvisc, supartz, etc) and life style changes (no jogging, low impact exercises). If one decides to undergo surgery, the meniscal problem is partially treated but the underlying arthritis still remains there and please realise that there is no surgical cure for arthritis. Also realise that taking out (shaving off) meniscus increases the loading forces on the knee so that after surgery many patients start experiencing more pain than before because the cushion effect of the meniscus is lost.

I would advise you to re-consult your doctor and ask him if he saw any underlying arthritis in your knee during arthroscopic surgery. If you indeed have arthritis, which I highly suspect you have, then the treatment modalities for you would be a combination of non-surgical options that I listed above.

A.  My guess is that you had a degenerative torn medical meniscus (not a traumatic one, which we see in younger folks) associated with Knee osteoarthritis.

If the torn degenerative meniscus is not causing any mechanical symptoms (locking, etc) the treatment usually is non-surgical with includes painkillers, Cortisone injection, viscosupplement injections (synvisc, supartz, etc) and life style changes (no jogging, low impact exercises). If one decides to undergo surgery, the meniscal problem is partially treated but the underlying arthritis still remains there and please realise that there is no surgical cure for arthritis. Also realise that taking out (shaving off) meniscus increases the loading forces on the knee so that after surgery many patients start experiencing more pain than before because the cushion effect of the meniscus is lost.

I would advise you to re-consult your doctor and ask him if he saw any underlying arthritis in your knee during arthroscopic surgery. If you indeed have arthritis, which I highly suspect you have, then the treatment modalities for you would be a combination of non-surgical options that I listed above.

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