From the Guidelines
No, a knee replacement should not have remittance, which refers to continued pain, swelling, or limited mobility after surgery. A successful knee replacement should provide pain relief and improved function, as seen in the study by 1, where the patient was ambulating independently without assistive devices and required no pain medications at 3 months postoperatively. If you're experiencing ongoing issues after knee replacement surgery, this is not normal and warrants medical attention. Contact your orthopedic surgeon promptly to evaluate the cause of your symptoms. Common reasons for persistent problems include infection, implant loosening, misalignment, or scar tissue formation. Your surgeon may recommend imaging studies such as X-rays or blood tests to determine the underlying cause, as suggested by the guidelines in 1. Treatment options depend on the specific issue but might include physical therapy, medication, or in some cases, revision surgery. Most knee replacements should provide good pain relief and function for 15-20 years or longer, as indicated by the high success rate of TKA in managing osteoarthritis of the knee, as reported in 1. Persistent problems after recovery indicate something is wrong that needs medical assessment rather than being an expected outcome that you should tolerate.
Some key points to consider in the management of knee replacement surgery include:
- The importance of proper preoperative management, such as weight loss and structured physical therapy, to optimize outcomes, as seen in the study by 1
- The use of spinal anesthesia and adductor canal block for perioperative pain control, as described in 1
- The initiation of twice daily postoperative physical therapy with full weight bearing, as reported in 1
- The potential need for imaging studies and blood tests to determine the underlying cause of persistent problems, as suggested by the guidelines in 1
Overall, knee replacement surgery should provide significant improvement in pain and function, and any ongoing issues should be promptly evaluated and addressed by an orthopedic surgeon, as supported by the evidence in 1 and 1.
From the Research
Knee Replacement and Remittance
- The provided studies do not directly address the question of whether a knee replacement should still have remittance 2, 3, 4, 5, 6.
- However, the studies discuss various aspects of knee osteoarthritis treatment, including pharmaceutical interventions 3, 4 and the importance of clinical reasoning in decision-making 2.
- The study on pharmaceutical treatment of osteoarthritis mentions that clinicians need to consider the latest evidence and recommendations to make informed decisions with their patients 4.
- Another study highlights the importance of considering the patient's autonomy and right to make decisions about their own care, even in emergency situations 6.
- The Precautionary Principle, which suggests erring on the side of caution in the absence of certainty, may also be relevant in decision-making about knee replacement and remittance 5.