Abstract
sympathetic block pain unit consultation (2) Causes of a painful TKR A. Intra-articular problems loose bodies overhanging component patellar clunk recurrent hemarthrosis gout/CPPD/RA persistent synovitis B. Periarticular problems pes anserine bursitis patellar tendinitis stress fracture heterotopic ossification C. Malalignment MCL strain in valgus knee tibial overload in varus knee rotational impingement patellar subluxation D. Instability flexion PCL sag anterior knee pain increased poly wear ‘start up pain’ medial/lateral global E. Systemic problems ipsilateral hip vascular claudication F. Neurologic complications peroneal entrapment reflex sympathetic dystrophy L3/4 HNP neurogenic claudication (spinal stenosis) 6. Patellar problems avascular necrosis stress fracture subluxation impingement patellar clunk H. Stiff knee limited pre-op motion tight PCL residual flexion contracture aggressive fibrous tissue response: 1. Patient issues unrealistic expectations limited pre-operative changes depression family dynamics.
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