Causes of Joint Stiffness from Knee Replacement Surgery Knee stiffness and pain that can occur after a knee replacement may be because of scar tissue and collagen attaching to the knee implant. This is called arthrofibrosis, and it is your immune system's reaction to the new “invader” in your knee.
It is common for 2 weeks to 3 months following the surgery.
Knee stiffness is a complication that may occur. Treatment options include aggressive physical therapy, manipulation under anesthesia, surgical removal of scar tissue, and revision knee replacement. Your surgeon will decide which treatment is best for your unique needs.
Three Months After Surgery
You may still be experiencing some minor stiffness in your knee. You may have some aching or swelling in your knee, especially after sitting for long periods or upon waking. You should be able to walk without a cane or walker. Your sleeping pattern should be back to normal.
Many clinical studies attribute this chronic pain to be the result of swelling (inflammation), damage to one or more peripheral nerves around the knee or other non-specific issues. In the past, when this chronic pain occurred, patients were left with few treatment options other than taking pain medication.
Causes of Joint Stiffness from Knee Replacement Surgery
Knee stiffness and pain that can occur after a knee replacement may be because of scar tissue and collagen attaching to the knee implant. This is called arthrofibrosis, and it is your immune system's reaction to the new “invader” in your knee.
Ongoing pain after knee replacement is complex and can be related to different factors. Factors known to be associated with ongoing pain include inflammation, infection, nerve damage, incorrect positioning of the replacement joint, and depression.
It's normal for patients to experience some degree of pain up to six months after surgery. However, if pain persists six months after the procedure, it's generally considered long-term or chronic. Several studies have examined chronic pain frequency among total knee replacement patients.
The most common contributing factors are poor range of motion (how well you can flex and extend your knee) before knee replacement surgery and poor adherence to physical therapy after knee replacement surgery. Intensive physical therapy after knee replacement can help reduce stiffness.
End of week 1: the goal is to reach at least 90° of knee flexion and be working towards full knee extension. Weeks 2-3: the goal is to achieve at least 100° knee flexion and full knee extension. Weeks 4-6: you should be approaching or have already achieved 110-120° of full knee flexion.
Slowly let your affected knee bend by lowering your feet. At some point, you will feel a gentle stretch. Hold for the desired amount of time, and then use your unaffected side to help straighten your knee out once again. Repeat.
Swelling after knee surgery is a very common occurrence and it's totally normal to experience it for several months or even up to a year after the procedure. So, don't worry too much if the swelling persists for a long time.
Implant failure
Knee implants are built to be long-lasting. But there's a small chance that the implant will fail. Implant failure is when the replacement joint isn't able to work properly. Typically, persistent pain and stiffness can be signs of implant failure.
Six months after your knee replacement
Usually by the 6 month mark, you're about 90% recovered. 30 out of 100 patients at 6 months will say “My knee feels pretty normal like the other side,” while the other 70 will say, “It's still not quite a normal knee but it's substantially better than what I had before.”
Start with small, manageable steps over short distances and use an assistive device whenever needed. Gradually work your way up until you can walk longer distances without discomfort. Doing too much exercise can lead to pain and swelling, hindering your recovery.
Arthrofibrosis, also known as “stiff knee syndrome,” occurs when excessive scar tissue forms around a joint, limiting range of motion and causing pain and disability. It can be a complication of knee replacement or anterior cruciate ligament surgery, with infections and bleeding as known contributing factors.
Knee replacement pain after three months
Many patients are back to their activities without the pain they had before surgery by this stage of recovery. If you find that any movement or activity is still exceedingly painful after three months, you may be experiencing chronic pain.
Rest, Ice, Compression and Elevation help lessen the swelling and pain. Exercise through physical therapy helps to strengthen the core and lower extremities and can help reduce pressure on your knees. Braces can help stabilize and take pressure off the knee.
Put the flat part of your fingers on the scar. Move the skin and tissue under the scar back and forth, holding for a few seconds. Make sure you press enough to feel the scar “move” under your fingertips. Move your fingers along to the next section of scar, and repeat until you've massaged all along the scar.
Chronic swelling can be a sign of an underlying medical condition. In many cases, swelling can be treated at home with painkillers and by elevating your leg. However, you should see your GP if you think your knee is infected, or if your swelling doesn't go down after a few days.
Once a knee has been replaced, the soft tissue around the joint will have a lot of adjusting to, to 'relearn' how to work properly. Massage can help increase blood flow around the body and circulate everything to help speed this process up.