What are the causes of post-arthroplasty pain?

  Artificial joints have developed rapidly over the past 20 years. Improvements in artificial joint materials and surgical techniques and awareness of post-operative complications have made joint replacement a reliable technique and tool for the treatment of end-stage joint disease, and the number of joint replacements in China has increased geometrically. There are several causes of post-operative pain that require special attention: Infection: Post-operative joint infection is one of the complications of joint replacement and should be considered first if post-operative pain persists. There are several reasons for this: First, there are potential foci of infection in the patient’s body prior to surgery, such as gingivitis, boils, foot infections, etc.  Secondly, the patient has diabetes mellitus with unsatisfactory blood glucose control Thirdly, the operating room is not ideal for aseptic conditions. The operating room of joint surgery should have laminar flow, too many people and frequent walking are strictly prohibited, and surgeons in hospitals with conditions wear space suits.  Fourth, the perioperative antimicrobial application method. The cephalosporin antimicrobial given within an hour before surgery is far more effective than postoperative has been making more than a week!  Factors of artificial joint prosthesis: First, the size and location of the prosthesis is poor, including hip prosthesis femoral stem is too long , knee prosthesis liner is too thick, internal and external rotation of the knee joint and poor force line will lead to recent joint pain and functional limitations.  Second, joint loosening, poor joint position and poor cementing techniques can lead to failure within 3 to 5 years after joint replacement.  Third, joint wear and osteolysis. It refers to the wear of the intra-articular interface, mainly polymer polyethylene wear, and in recent years, metal-to-metal and ceramic-to-ceramic are used to effectively avoid such complications. Osteolysis refers to wear micro-particles resulting in macrophages engulfing micro-particles while eroding the bone around the prosthesis resulting in bone loss. bone defects around the prosthesis can be seen on X-rays.  Fourth, the type of joint prosthesis selection error artificial joint variety, including cemented non-cemented type, the first replacement prosthesis and revision prosthesis, prosthetic surface coating also varies. Domestic artificial joints have also surged in recent years, with no less than a dozen manufacturers of all sizes. At present, the knee joint replacement is mostly cemented, while the hip joint is generally cemented at the age of over 70. Patients with congenital acetabular dysplasia are better off with a matched prosthesis. Wrong choice leads to undesirable results.  Of course, external factors can also cause the joint to be short-lived. For example, overuse, falls, obesity.  The recent pain in the artificial joint is not relieved by prompt medical attention.