The most common reason patients seek knee replacement is for relief from pain. Despite that, an unacceptably high percentage of patients have chronic pain after knee replacement. What has been done to figure out how to prevent, or treat, chronic postsurgical knee replacement pain? A new study reveals the alarming truth…almost nothing!
Knee replacement is big surgery, fraught with big risks and complications the average patient signing the release forms often doesn’t fully grasp. It’s very easy to understand that a “new knee” sounds like a much better idea than the old one that has caused so much pain, especially given the unrealistic expectations that saturate the media. But with alarmingly serious complications, at alarmingly serious rates, like heart attack, stroke, muscle death, cognitive and memory issues, ongoing metal toxicity and even possible cancer links from it, one would at least expect that after the lengthy recovery, there would be no more pain!
Towards that end a study sought to evaluate the effectiveness of predictive models to suggest preventative care for chronic pain after knee replacement, and for interventions in the management of chronic postsurgical knee replacement pain. To do this they did a systematic review of randomized controlled trials of adult knee replacement patients from 3 major databases. They found not one study evaluating the effectiveness of predictive models in guiding treatment and improving outcomes. Their search revealed only one study which tested a chronic pain intervention, a specific type of botulism injection, which worked for 40 days. But no further study on that treatment has been done. The study concluded that developing evidence based care for knee replacement patients needs to become a research priority. Yikes!
The upshot? Chronic pain after knee replacement is surprisingly common. Many things factor into outcome, but major studies put the numbers between 10 and 54%, with the average being around 30%. One recent study found that 54% of patients had knee pain 5 years after knee replacement surgery, and 87% of those patients’ knee pain developed only after surgery! But the most alarming thing of all is, if you end up on the wrong side of those percentages, nobody seems to know how best to help you!