Knee Steroid Injections and Adhesion Surgery Outcomes

Knee steroid injection and adhesion surgery?

Hello, doctor.
I am currently over three months post-ligament reconstruction.
My knee flexion angle is not as expected, and I experience pain while walking, along with crepitus during flexion.
During my follow-up appointment this week, my attending physician administered what I believe was a steroid injection into my knee.
After the injection, my knee pain significantly worsened, and I was even unable to walk for a time.
It has been three days since the injection, and the area around the injection site is still very painful.
I experience a dull ache whether I am walking or at rest, and it is particularly noticeable during flexion.
Is this normal? How long will it take for the pain to subside?
Additionally, I would like to ask if having a knee flexion of 105 degrees actively and 110 degrees passively after over three months is suitable for adhesiolysis surgery.
If I undergo this procedure, will the recovery period necessarily be shortened? If I choose not to have the surgery and continue with rehabilitation, is it guaranteed that the adhesions will loosen? I would like to understand the differences between having the surgery and not having it.
Thank you, doctor!

Nìmíng, 20~29 year old female. Ask Date: 2018/05/04

Dr. Li Yongheng reply Orthopedics

Hello, based on your symptoms, it is possible that you may still experience pain for three days after the steroid injection, but the pain should improve within about a week.
Currently, there is limited range of motion in your knee joint, and it is recommended that you consider manual reduction.
If manual reduction does not lead to improvement, then surgical intervention to remove adhesions may be considered.
Wishing you a speedy recovery.

Reply Date: 2018/05/04

More Info

Understanding knee steroid injections and the outcomes of adhesion surgery is crucial for effective recovery following knee ligament reconstruction. Your situation, where you have experienced pain and limited range of motion three months post-surgery, is not uncommon. Let's break down your concerns regarding the steroid injection and the potential for adhesion surgery.

Steroid Injection After Knee Surgery
Steroid injections, such as corticosteroids, are often used to reduce inflammation and pain in the knee joint. After such an injection, it is typical for patients to experience some discomfort at the injection site. This pain can last for a few days to a week, and it is generally a result of the injection itself, the body's inflammatory response, or the underlying condition being treated. In your case, experiencing significant pain three days post-injection is not unusual, especially if the knee was already inflamed or if there was existing irritation from the surgical procedure.
Typically, the pain should start to diminish within a week as the steroid begins to take effect. If the pain persists beyond this period or worsens, it is essential to follow up with your physician to rule out any complications, such as infection or an adverse reaction to the steroid.

Range of Motion and Adhesion Surgery
Regarding your knee's range of motion, achieving 105 degrees actively and 110 degrees passively is a positive sign, but it may still be below the expected range for optimal function. Adhesions, or scar tissue, can form after surgery and may limit movement. If you are experiencing significant pain during movement, it could indicate that adhesions are affecting your knee's mobility.

The decision to proceed with adhesion surgery (arthroscopic lysis of adhesions) should be based on a thorough evaluation by your orthopedic surgeon. Generally, if conservative measures, such as physical therapy, have not improved your range of motion or if pain persists, surgery may be considered.

Recovery and Rehabilitation
If you decide to undergo adhesion surgery, the recovery period can vary. Some patients experience a quicker return to function post-surgery, while others may require additional rehabilitation to regain full motion. The surgery aims to remove the adhesions, which can potentially lead to improved range of motion and decreased pain. However, it is crucial to engage in a structured rehabilitation program after the surgery to maximize the benefits and prevent the recurrence of adhesions.

On the other hand, if you choose to continue with conservative management through physical therapy, it is possible to improve your range of motion over time. Many patients find that with consistent and targeted rehabilitation, they can gradually reduce adhesions and improve function without the need for surgical intervention. However, this process may take longer, and results can vary significantly from person to person.

Conclusion
In summary, experiencing pain after a steroid injection is common and should improve within a week. The decision to undergo adhesion surgery should be made in consultation with your orthopedic surgeon, considering your current range of motion and pain levels. Both surgical and non-surgical options have their merits, and the best choice depends on your specific situation, goals, and response to rehabilitation. Always keep an open line of communication with your healthcare provider to ensure you are making informed decisions about your recovery.

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