Editorial
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2014; 5(3): 163-170
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.163
Anterior knee pain after a total knee arthroplasty: What can cause this pain?
Stéfanus Jacob Martinus Breugem, Daniël Haverkamp
Stéfanus Jacob Martinus Breugem, Orthopedic Clinic, Orthopedium, 2616LS Delft, The Netherlands
Daniël Haverkamp, Department of Orthopedics, Slotervaart Hospital, 1066EC Amsterdam, The Netherlands
Author contributions: Breugem SJM as primary author wrote, revised and approved the final manuscript; Haverkamp D as secondary writer made critical revisions and gave final approval.
Correspondence to: Stéfanus Jacob Martinus Breugem, MD, Orthopedic Clinic, Orthopedium, Olof Palmes straat 20, 2616LS Delft, The Netherlands. sbreugem@orthopedium.nl
Telephone: +31-88-0088444 Fax: +31-88-0088445
Received: December 28, 2013
Revised: March 28, 2014
Accepted: April 17, 2014
Published online: July 18, 2014
Abstract

Total Knee Arthroplasty has been shown to be a successful procedure for treating patients with osteoarthritis, and yet approximately 5%-10% of patients experience residual pain, especially in the anterior part of the knee. Many theories have been proposed to explain the etiology of this anterior knee pain (AKP) but, despite improvements having been made, AKP remains a problem. AKP can be described as retropatellar or peripatellar pain, which limits patients in their everyday lives. Patients suffering from AKP experience difficulty in standing up from a chair, walking up and down stairs and riding a bicycle. The question asked was: “How can a ‘perfectly’ placed total knee arthroplasty (TKA) still be painful: what can cause this pain?”. To prevent AKP after TKA it is important to first identify the different anatomical structures that can cause this pain. Greater attention to and understanding of AKP should lead to significant pain relief and greater overall patient satisfaction after TKA. This article is a review of what pain is, how nerve signalling works and what is thought to cause Anterior Knee Pain after a Total Knee Arthroplasty.

Keywords: Anterior knee pain, Patellofemoral pain, Total knee arthroplasty, Malrotation, Homeostasis

Core tip: Total knee arthroplasty (TKA) has been shown to be a successful procedure for treating patients with osteoarthritis, and yet approximately 5%-10% of patients experience anterior knee pain (AKP). To prevent AKP after TKA it is important to first identify the different anatomical structures that can cause this pain. Greater attention to and understanding of AKP should lead to significant pain relief and greater overall patient satisfaction after TKA. This article is a review of what pain is, how nerve signalling works and what is thought to cause AKP after a TKA.