Hoping you can shed some light. A year ago July, my mom had knee replacement and was doing fine until she fell and broke ball in hip on the opposite leg. The set-back was depressing, but we got through it. She is 80 years old. This past 3 weeks, she is complaining of pain in/above the knee replacement. Sometimes a burning sensation. When sitting, if she tries to raise her leg and extend horizontally, it is painful. She can not longer go up and down stairs with the ease she once had.

Her doctor took ex-ray and saw no infection. Leg is slightly swollen, but the incision is clean and not red; though the leg is continuously ‘warm’. Doctor says from looking a leg that atrophy has set in and recommends PT. I am concerned that this does not make sense. She is active at home, always going up and down the 12 stairs and drives and goes grocery stopping, cooks meals etc. Since she has a stint in her heart area, no MRI is recommended. What further course of testing or investigation can we do to find out the cause. I’m nervous that the PT may damage her state further. So far we are using anti-inflammatory and pain killers; doctor has suggested an epidural so she can do the PT.

Sincerely Joyce Velehradsky

-- Joyce Velehradsky (rejoyce7@optonline.net), July 18, 2004

Answers

my husband had knee replacement 3 years ago and still has constant pain. He has had a cat scan which showed that the glue broke and he needs another knee put in. So a ct can be done on your mother. good luck

-- Deb Belles (DBELLES@twcny.rr.com), July 30, 2004.

While it is obviously not possible to recommend a treatment approach for a particular patient without a full evaluation, I can offer the following general observations. It is not uncommon for a knee to still be warmer than the other side at one year after a replacement. It is uncommon for an infection to show up for the first time one year after a knee replacement. It is not impossible but it would be uncommon. The symptoms that are described could be coming from compression of nerves in the back. The fact that the treating physician has suggested an epidural indicates that he may be thinking of that is well since this is one of the treatments.

The best advice that I can give you is to express your concerns to the physician and ask for clarification of anything that you don't understand. If you are not satisfied with the answers or the way the treatment is going, seek a second opinion.

D.S. Hungerford, MD

-- David S. Hungerford, M.D. (dhunger@jhmi.edu), August 12, 2004.