Total knee prosthesis is the most effective treatment that can be done in patients with advanced calcification, to relieve the pain of the patient, to improve the movement and thus the quality of life. Despite the high success rate of surgeons today, approximately 20% of patients with knee prostheses continue to have post-operative pain. The onset of the pain causes both the patient and the physician to be unhappy and reveals some social and judicial problems. Although there are many factors that can cause pain, about 10% of patients are not able to establish a definite cause. Therefore, in the majority of patients who are still suffering from pain, it is necessary to first seek out non-surgical treatments instead of a surgery.
A detailed and rigorous evaluation is needed to reveal the causes of pain in prosthetic patients. This may require a proper examination, some blood tests, joint fluid analysis, and some specific imaging modalities.
As a result of the questioning and evaluation of the patient, some hints can be obtained. For example; If the patient's pain continues unchanged after the surgery, it can be thought that the pain may be caused by an abnormality other than the knee joint. Therefore, an unnecessary maelic is made. Muscle weakness, infection, prosthetic imbalance are considered in patients whose pain persists immediately after surgery. If the pain of the patient after the surgery has begun again after a long time in the past, prosthetic wear, late infection, and stress fracture should be remembered. In severe pain with tender skin, the nerve tumor we refer to as neuroma comes to mind.
Untreated treatments are tried until a definite cause is found in the treatment of patients with painful prosthesis. Physiotherapy, painkillers, some supporting devices are applied for at least 3 months. Some diseases may be injected with local anesthetic for diagnostic and therapeutic purposes. Blockade treatments for the index nerves may be useful in patients with chronic pain. Nerve burning therapy with radiofrequency is also one of the most effective of these treatments.
Such patients do not need closed knee surgeries. Liacin is very rare and can be done in some special situations. According to statistics, two thirds of patients with painful prosthesis remain unfortunately forced to undergo another operation. The most important reasons for reoperating these patients is that the previously inserted prosthesis can not be fully inserted and tissue hardening occurs.