Persistent Knee Pain After Injury (or Arthroscopy)

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

For some patients, they come to see us because they had a “technically successful” surgery—perhaps even an arthroscopic procedure—following a knee injury, and yet were still having severe, chronic refractory knee pain.Runner holding his knee due to pain

If you’ve had surgery to repair a knee injury of any kind, and everything went as your surgeon expected it to, but it’s been 6 months (or longer) and you’re still having excruciating pain, there’s definitely a problem. The silver lining in this case is that it might be a problem we can fix for you.

In these cases, there are two important parts:

  1. You are having symptoms that may include sharp or searing pain, “pins and needles” sensations, the feeling as though your knee is plugged into an electrical socket, or hypersensitivity (to the point even the lightest touch causes severe pain).
  2. The initial surgical procedure went exactly as it should have and your orthopedic surgeon says that you should be feeling better (even though you aren’t).

So instead of having the excellent, normal function you were expecting, you’re actually suffering from pain in and around the knee joint. This pain can range anywhere from mild to severely debilitating, and no matter where it falls on the pain spectrum, the fact remains – you were expecting to have your knee problem resolved and it hasn’t been.

Even more frustrating is when new symptoms have developed in the area!

Typically, the operating surgeon in these cases actually did everything by the book and it really isn’t his or her fault. With that being the case, something else is responsible. The good news is that we might be able to identify this problem for you.

In all likelihood, the nerve pain you have been experiencing is the result of entrapment, injury, or even stretching of the nerve endings that travel to the soft tissue around the knee joint and to the skin covering and around the knee.

During your operation, the affected nerves may have been divided, stretched, or cut. Since there is obviously cutting that happens during surgery, this is actually unavoidable in most cases. Further, it’s something that happens even in the hands of the world’s best orthopedic surgeons.

Often, patients who develop the aforementioned kinds of symptoms are diagnosed with either “RSD” (reflex sympathetic dystrophy) or “CRPS” (chronic regional pain syndrome). The problem with diagnoses like these is that patients are usually then referred to prolonged physical therapy and the medical pain management world for nerve blocks, injections, and medications.

It’s obviously quite positive when those treatments lead to patient improvement over time. For some patients, however, the debilitating pain continues up to, and beyond, six months following the surgery. When this is the case, it’s time to take a closer look and try to determine what exactly is causing all of that pain.

So, what is likely the source? Frequently, we find this to be a matter of injured nerves that both go into to the joint itself and the skin around the joint. Because of their injuries, these nerves now send signals the brain interprets as pain.

Resolving this problem is a matter of treating and effectively addressing these injured nerves. Doing so can lead to marked improvement for patients who have been suffering from chronic knee pain after knee surgery (once all other correctable orthopedic causes have been ruled out, of course).

If this sounds like a problem you are experiencing, and you have already consulted your orthopedic surgeon to determine if there are any other possible explanations, come see us. We may be able to help you find the relief you need. Request your appointment with our Baltimore office by calling (410) 337-5400 and one of our team members will be happy to help.

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