A member asked:

What causes patellofemoral pain syndrome after a tkr?

14 doctors weighed in across 6 answers

It depends....: On whether the patella was resurfaced. Some patients will still have pain if their patella was not resurfaced. They may have damaged cartilage on the knee cap that is rubbing against the implant. Unfortunately resurfacing the kneecap later often only helps about half the patients. Talk with your surgeon or get a second opinion. There may be something else going on like loosening or infection.

Answered 12/2/2014

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Complicated: Might be scar tissue.My be stiffness, might be malpositioning of a component. Might be quad weakness. Might be infection, might be loosening. Too many possibilities.

Answered 12/30/2014

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Adhesions: There are three reasons. One is the complication of postoperative adhesions which is build up of scar tissue after surgery. The other is if your surgeon did not replace the patella surface you could be having pain due to the contact of the patella natural cartilage against the metal femoral component. The last is that the patella is not tracking properly as you bend your knee.

Answered 9/28/2016

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Dr. David Fisher answered

Specializes in Orthopedic Surgery

Multiple causes: Peripatellar pain after tka can be caused by a number of conditions. Unresurfaced patellas can be painful. Patellar implant loosening. Undersized patellar implant leading to bone irritation. Scar formation (fibrosis). Tendonitis of the patellar or quadriceps tendons. Infection. Fibromyalgia. Fracture. Referred hip pain. Neuroma of a branch of the saphenous nerve.

Answered 10/2/2015

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Dr. Daniel Ivankovich answered

Specializes in Orthopedic Spine Surgery

Causes For Knee Pain: There's many reasons why a painful total knee replacement would persist a year after surgery. Who assigned you a diagnosis "patellofemoral pain syndrome" ? It would help to know if your patella was resurfaced at the time of total knee arthroplasty. There can be excess scar, mal-alignment of components, quadriceps weakness or other reasons for your pain. It's also critical to rule out infection.

Answered 1/22/2019

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It depends: Anterior knee pain after replacement may be from slight malrotation of the femoral component, referred pain from the hip or lower back (l4 nerve root), or neuroma. A 13-month-old painful knee replacement should be aspirated for infection, blood work should be done to check sed rate and crp, and bone scan should be done to look for loosening.

Answered 1/21/2014

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