Is your knee pain worse after revision surgery even though at first it wasn’t so bad?

A knee revision surgery is when a failed or loosened implant is replaced in part or whole by new hardware, but what does it mean if soon after this procedure, the knee pain is a 9 or 10 out of a 10 pain scale?

Might this mean that the knee revision surgery failed? My father recently had a knee revision surgery.

In the several days after the knee revision surgery, while he was still in the hospital, he reported that everything felt fine, other than the surgical pain, which is to be expected with these procedures.

He spent four days in the hospital. The fourth night after the knee revision surgery, he slept at his house, and next morning, reported that the knee felt good (there was pain, of course, but this was related to the procedure).

However, next day, he said it was hurting bad and became concerned. I noticed that he wasn’t walking as much (the doctor told him to use a walker for the next three weeks, then a cane for three weeks after that).

The next day it was still worse, and he couldn’t help but wonder if the knee revision surgery actually failed, even commenting that maybe something in there was loose.

Interestingly, his physical therapist, who came to the house, noted some oozing from the incision, and decided that this, in combination with the severe pain, might mean an infection.

The PT contacted the surgeon’s office; he was told that my father should report to the emergency room.

I drove him there. The ER doctor said the knee didn’t appear to be infected. An X-ray was normal.

A blood test also was normal. An orthopedic physician’s assistant then examined the incision, feeling the joint, and said everything was normal. So what was up with all the pain?

The P.A. explained that after knee revision surgery, the patient is up and walking within 24 hours. Each day after, the patient walks a little more, feeling “great.”

Then come maybe the fifth or sixth day after knee revision surgery, the patient reports an increase in pain, sometimes dramatic.

This is because, said the P.A., the joint has become overworked. The patient typically cuts back on walking and becomes more inactive. This gives the joint a chance to recharge.

When the pain diminishes, the patient eagerly begins walking again, and may again overdo it, bringing on a resurgence of the pain.

It’s an up and down cycle, said the P.A., that can persist for a few weeks, but over time, as the joint heals, it won’t respond so much with pain from all the walking.

My father had a follow-up visit a few days after with his primary care physician, who basically said the same thing.

The joint looked perfectly normal, and that pain comes from walking too much (which doesn’t necessarily mean a marathon  —  remember, knee revision surgery is very traumatic to the joint, and what seems like normal walking about the house can easily qualify as “overdoing it”).

If you’ve recently had knee revision surgery and the pain has suddenly gotten worse, this might be due to “overdoing it,” but get a prompt follow-up with your primary care doctor to be sure.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 
Top image:  Dave Haygarth