Why am I still having knee pain?

I am a 41 yr old female with chronic knee pain. I had a Posterior Cruciate Repair done on my knee when I was 14. No problems afterwards until reinjuring it in a fall in 2007. Since then Ive had 3 surgeries the last one being a TKR on 6/07/11. I am still experiencing a 5 or greater rate of pain though my surgeon says the x-rays look fine. He said it will take several months of PT before the swelling and pain to get better. I have great range but the pain is awful! I am still going to a Pain Management Doctor but just wondering if I can really expect to be "pain free" or is this unrealistic? I have known some people with no problems with ongoing pain after surgery and some (like I`m beginning to feel) that wish they hadnt had it done. It`s definately a different kind of pain but nevertheless almost unbearable.

[S. Kaul, MD]

Hi there!

Though it usually takes a few (4-8) weeks for the pain and discomfort to subside after the surgery, many patients experience discomfort upto 12-16 weeks post the procedure. While the healing is largely natural, physiotherapy helps the healing process and shortening the recovery time; and is highly recommended in your case. Aside prosthetic causes like peri prosthetic fracture, wearing of the bearings, loosening of prosthesis; other causes like infections, inflammations, neurovascular damage, ligamental/ tendon injuries, osteolysis, synovitis etc may need to be considered in cases that fail to show improvement. For the time being I would recommend physiotherapy for a few more weeks and see if this seems to help. You may also try NSAIDS for symptomatic relief. If things do not seem to improve within 3-4 months, I would recommend a re-evaluation by your orthopedician to rule out the above mentioned secondary causes.
Hope this helps.

Take care!