Nuisance symptoms following knee replacement surgery

Knee replacement surgery is one of the most successful surgeries in orthopedics. Patients generally have a tremendous improvement in pain and most patients are satisfied with their surgery. While a knee replacement is capable of restoring normal “functioning,” it is not exactly restoring a “normal” knee. There are some symptoms following a knee replacement that are best described as nuisance symptoms. These symptoms do not necessarily influence satisfaction or function but can be noticeable after knee replacement. We will examine the most common nuisance complaints in my practice following knee replacement surgeries.

 1.     Clicking sounds in the knee: These sounds are usually present with activities. They are often due to the metal and plastic components of a knee replacement moving against one another. Sometimes, they can be due to the formation of scar tissue around the patella (knee cap). These clicking sounds usually do not affect functioning, and rarely do they affect patient satisfaction. They do not need additional surgical interventions. 

 2.     Numbness: Numbness on the outside of the knee after surgery affects everyone. This is because there is a superficial nerve that is cut whenever a knee replacement incision is made. As such, every patient would have a patch of numbness on the outside of the knee after knee replacement surgery. For some patients, the patch of numbness decreases over time. For others, it doesn’t change. Nevertheless, this numbness doesn’t affect functioning and rarely affects satisfaction following knee replacement surgery. 

3.     Painful kneeling: Most patients are able to kneel without pain after surgery. However, a small percentage of knee replacement patients would be unable to kneel comfortably following the surgery. These affected patients would benefit from the use of knee pads if there is a need for prolonged kneeling.  

4.     Knee swelling: All patients will have swelling in the knee after knee replacement surgery. This swelling will decrease over time, and can take as long as 3 to 6 months to go away. A small percentage of patients will have prolonged, intermittent swelling. This can occur with activities, but usually doesn’t affect functioning of the knee.

5.     Weather-related soreness: Some patients would experience increased soreness in the replaced knee when the weather gets cold. This soreness is not described as pain and gets better when the weather gets warmer without any intervention. The weather-related soreness gets better with time in the majority of patients and doesn’t affect functioning of the knee replacement. 

6.     Stiffness: Some patients would complain of a sense of stiffness in the knee. This can occur even in the presence of a full range of motion. This can be due to trace swelling in the knee or thickening of the knee tissue that can occur after knee replacement. It usually gets better with time, and doesn’t affect functioning if with full knee motion.