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Joris Bartstra, doctor and journalist, answers reader questions
Since June 2018 I (woman, age 66) have had a total knee replacement. From the beginning there is something in my knee that hurts when climbing stairs and high pavements. Just walking is fine. Is keyhole surgery a good idea? Nothing can be seen in the photo and scan.
One tricky issue: pieces of bone or cement should show up in the photo unless it’s a very small piece. During keyhole surgery in an artificial joint, the risk of infections is much greater because bacteria that are once on a ‘work of art’ can (almost) not be cleared up by the body. This often means that the prosthesis has to be removed and if you are unlucky, something can only be put back in its place months later; that means months in a wheelchair.
So I can imagine that the orthopedist is hesitant about keyhole surgery. For such a relatively limited inconvenience and the limited chance of it being resolved, I wouldn’t take the risk myself. Pain complaints after a knee prosthesis are often caused by a sub-optimal rehabilitation. In any case, having it looked at again by a physiotherapist is not risky. Furthermore, after persistent pain complaints, it is sometimes concluded that the prosthesis is not properly secured, but here too the only solution is a new operation.
Sources):
- Plus Magazine