Bursitis after knee replacement
A group of patients may experience pain caused by bursitis after knee joint replacement surgery, which is performed due to serious joint injuries or following advanced arthritis.
The inflammation of the small cushion that is placed between the tibia bone and the tendon of the thigh muscle and is called Pes Anserine Bursitis is the most common type of knee bursitis after knee replacement surgery.
If you have had a knee replacement and then have knee pain, in this article we are going to provide a detailed explanation about bursitis after joint replacement surgery.
Epidemiology
What is bursitis?
In all the joints of our body, very small bags called bursae are installed to reduce friction between tendons, reduce bone and tendon wear, and facilitate joint movements.
In the inner wall of the bursa, there are cells that secrete a natural substance and this natural substance fills the inside of the bursa.
Any factor that irritates the bursa, in response to it, the cells of the inner wall will increase the secretion of fluid inside the bursa, the increase of fluid inside the bursa will increase the volume of the bursa and put pressure on the nerve fibers and tissues adjacent to the bursa, and therefore pain and discomfort and also reduce in the range of motion of the knee is caused.
Any kind of irritation of the bursa causes inflammation of the cells of the inner wall of the sac; infections, excessive activity of the knee joint, such as excessive bending and straightening of the knee, trauma and direct blow on the knee, and etc. all can cause inflammation of the bursae or bursitis knee.
In summary:
Bursitis means inflammation of small joint sacs, i.e. bursae.
Bursitis is common in body joints such as knees, shoulders, elbows and hips.
One of the causes of knee bursitis is joint manipulations and knee joint replacement surgery, which is the subject of this article.
Knee bursitis after knee replacement surgery
Manipulation of the bent knee during knee replacement surgery is a common cause of knee bursa irritation and inflammation.
The most common bursa that becomes inflamed after knee joint replacement surgery is the Pes Anserine bursa.
Where this bursa is located, the most common symptoms of bursitis after knee joint replacement and the definitive treatment of pain caused by knee bursitis after joint replacement, etc. is the subject of this article.
Epidemiology:
Studies have shown that twenty percent of people experience knee pain after knee replacement surgery.
The presence of underlying problems may be a reason for increasing the risk of knee pain after joint replacement.
The statistics presented in the above section are for people who have done total knee replacement .
The causes of pain after total knee joint replacement are different, and knee bursitis is only one of the reasons for the recurrence of pain after surgery.
Pes Anserine Bursitis
Pes Anserine bursa inflammation is more common after knee joint replacement than other knee bursae inflammations.
Where is this bursae located?
The Pes Anserine bursa is a small sac that is located between the tendon of the hamstring muscle (located on the medial side of the knee) and the tibia (the large leg bone located on the medial side of the leg).
What causes inflammation of this bursa?
People who bend and straighten their knee too much for any reason are prone to this type of bursitis
Type 2 diabetes, arthritis, and underlying diseases of the knee joint increase the risk of developing this bursitis.
Symptoms of bursitis after knee replacement surgery
The most common symptoms are:
- Knee pain that is commonly two or three inches below the medial side of the knee.
- The inflamed bursa is sensitive to the touch
- swelling
- Decreased ability of the patient to move the knee (decreased range of motion of the knee)
- in some cases:
- There is also a knee locking.
- There is usually pain during activity.
In rare cases when bursitis is septic, there is severe and increasing pain, fever, and the inability of the affected person to put weight on the knee.
after knee joint replacement surgery, infection of bursitis in people who have a weak immune system, for example, those who have taken immunosuppressive drugs, or for example, those with rheumatism, or people who have uncontrolled diabetes, is possible to experience.
The most common type of bursitis after knee joint replacement
Pes Anserine Bursitis is the most common type of bursitis after total knee replacement.
Because the above bursa is located next to the medial collateral ligament of the knee, sometimes it is also called MCL bursitis.
When there is a lot of knee flexion and extension, i.e. a lot of bending and straightening of the knee, this bursa gets irritated and inflamed.
Knee joint replacement surgery
This surgery has different types and techniques and different prostheses are used for replacement.
Of course, just suffering from joint rheumatism or rheumatoid arthritis or arthrosis, etc., does not make your doctor suggest knee joint replacement surgery for you.
What causes you to be a candidate for knee joint replacement surgery?
When knee pain prevents you from doing your daily activities.
When the pain has not responded with non-surgical treatments
Severe changes in the shape of the knee joint
Excessive destruction of the knee joint in advanced rheumatoid arthritis
Destructive traumas of the knee joint
Diagnosing the causes of pain after knee joint replacement
getting a detailed history and examination of symptoms associated with knee pain.
Examination of the knee joint
and in some cases joint fluid aspiration
Sometimes it will be necessary to perform imaging of the knee, but most of the time, the diagnosis of knee bursitis is clinical and does not require the use of diagnostic methods.
Treatment of bursitis after knee joint replacement
- Rest and reduce activities that lead to pain.
- Elevating the leg to reduce swelling
- Cold compress to reduce inflammation and swelling
- Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen for a short period of time
And
- Specialized physiotherapy
will cure the bursitis completely most of the time.
Note:
If you have had a knee joint replacement surgery, emergency referral is required in the following cases:
Increasing severe pains
Fever
The inability of the affected person to put weight on the affected leg
Severe pain with warmth of the joint and redness of the skin of the knee.
Final word
Twenty percent of all people who have total knee surgery experience knee pain after surgery.
Knee bursitis is only one of the causes of knee pain after surgery.
The most common bursa involved after knee replacement surgery is the bursa that is located on the medial side of the knee joint between the tendon of the hamstring muscle and the tibia, and is called the Pes Anserine bursa or MCL.
Pain two to three inches below the medial side of the knee, especially when bending and straightening the knee, and reducing the range of motion of the knee are symptoms of this bursitis.
People with arthritis and diabetes are more prone to this disease.
Bursitis after knee joint replacement surgery is often resolved with supportive care methods, and you will get through it well with physical therapy.