Pain with an artificial knee joint

The most common cause of this problem is trapped scar tissue. Pain can occur early on after an artificial knee joint operation or later on. Typical is a rather sharp or stabbing pain in the area of the joint space. Some patients are familiar with this pain from earlier, for example from a torn meniscus. The movement-dependent pain usually increases because the trapped scar tissue between the artificial femoral component and the plastic disc (inlay) repeatedly becomes trapped with every movement and is injured as a result. This causes the tissue to bleed, leading to inflammation. As a result, the trapped tissue becomes larger over time and the stabbing pain becomes more frequent and more intense.

Different reasons for entrapment

There are various causes for the formation of scar tissue. It can be caused by an accident with haemorrhage into the joint, by overstimulation of the surrounding tissue of the knee prosthesis or by insufficiently balanced collateral ligaments. If the collateral ligaments are not equalised, the artificial knee joint is guided too little. This can cause tissue on the loose side to become trapped and trigger the corresponding pain. Overstimulation of the tissue can occur if the artificial joint is not positioned optimally, if too large components have been used, if allergies to the prosthesis made of nickel, chromium or cement components occur, if the osteoarthritis progresses behind the kneecap, if the course of the kneecap is not optimal or if the artificial joint is overstressed.

First therapy, then surgery

If the stabbing pain does not go away and the quality of life is restricted as a result, the knee joint should be examined by a knee specialist and possible causes clarified. Once these have been identified, the treatment will be determined accordingly. This can range from conservative (without surgery) such as physiotherapy, insoles and painkillers to surgery. Depending on the cause, there are also different surgical options. For example, arthroscopy can help to remove trapped scar tissue and improve the course of the kneecap, thereby preserving the artificial joint. Other surgical options include artificial replacement of the back surface of the kneecap, reconstruction of the leading ligament of the kneecap (MPFL) or revision of the artificial joint with corresponding removal and replacement with a new artificial joint.

You can find more information about knee surgery here.

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Dr Andreas L. Oberholzer is a recognised expert in knee problems and has extensive experience in the field of artificial knee joints and alternative treatment methods.

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