New Knee Joints in the BalanceMost patients who have a total knee replacement (TKR) report a good outcome. This can be directly linked to the skill of the surgeon. Stiffness and pain after TKR are mostly due to the way the operation was done. For example, painful symptoms occur if one ligament is too tight or if the implant is too large and hangs over the edge of the bone.
Other causes of problems after TKR may be infection, failure of the implant to work properly, or psychological effects. These aren't usually under the control of the doctor.
Doctors who replace knee joints try to restore the natural joint connection as much as possible. They also work to regain a balance of the soft tissues, such as the muscles, ligaments, and tendons. One ligament can't be tighter than another, and the new joint mustn't rub the wrong way against ligaments and tendons.
If problems occur after TKR, the doctor should try to find out what's causing the problems. Surgery to revise the new joint shouldn't be done until the source of the pain and stiffness is found. This improves the odds of success. Even so, most patients who need surgery to revise a TKR shouldn't expect to get full motion back. They commonly do, however, improve their range of motion enough to make the knee more functional.
John M. Cuckler, MD. The Stiff Knee: Evaluation and Management. In Orthopedics. September 2002. Vol. 25. No. 9. Pp. 969-970.
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