Why Does Knee Pain Continue After Fracture Fixation? By Dr. Kashyap Solanki – Orthopaedic & Joint Preservation Surgeon, Mumbai

1) Malalignment After Healing

Even a few degrees of mismatch in bone healing can change your knee mechanics.

• Weight bearing shifts abnormally

• Cartilage overload develops

• Early arthritis may start

  
  

Example: A varus (bow-leg) angle after fracture → pressure increases on the inside knee → chronic pain.

Corrective osteotomy can realign bones and relieve stress.

2) Cartilage Damage at Time of Injury

High-energy trauma often injures cartilage, even if not seen initially.

Symptoms:

• Pain while sitting & standing

• Clicking/rough grinding

• Swelling after activity

Treatment options:

• PRP injections

• Microfracture

• Cartilage transplant (MACI/OATS)

  
  

3) Unrecognized Ligament or Meniscus Injury

Traumatic knee injuries commonly involve multiple structures.

You may have:

• ACL/PCL sprain or tear

• Meniscus tear

When untreated, this leads to:

• Instability

• Recurrent swelling

• Pain during pivoting

  
  

4) Hardware-Related Pain

Plates, screws, or wires sometimes irritate surrounding tissues.

Signs:

• Local tenderness along implants

• Pain with kneeling

Solution: Hardware removal (after bone consolidation)

5) Post-Traumatic Arthritis

Even after successful fixation, cartilage damage + alignment change → early wear.

Typical symptoms:

• Morning stiffness

• Pain with stairs

• Weather-related pain

6) Muscle Weakness & Poor Rehab

After fracture:

• Quadriceps weaken

• Hip/core compensation occurs

• Patellofemoral pain develops

Physiotherapy targets:

• Quadriceps strengthening

• VMO activation

• Hip-core strengthening

• Gait correction

Warning Signs — See Your Surgeon

Seek evaluation if you notice:

Symptom	Possible Cause
Locking / catching	Cartilage or meniscus injury
Instability	Ligament tear
Persistent swelling	Joint irritation/arthritis
Pain along metal plate	Hardware irritation
Limping months after surgery	Malalignment or weakness

Investigations

• X-ray standing full-length scanogram → alignment check

• MRI → cartilage/meniscus/ligaments

• CT → complex fracture malunion

Treatment Options

Problem	Treatment
Weak muscles	Physio + gait training
Hardware irritation	Removal
Malalignment	Corrective osteotomy
Cartilage injury	PRP / stem cell / cartilage surgery
Post-traumatic arthritis	Joint preservation or TKR (last resort in young)

Return to Activity Tips

• Start closed-chain exercises

• Gradual loading only

• Weight control & quadriceps strengthening

• Omega-3, calcium, vitamin D, protein rich diet

Key Takeaway

Persistent knee pain after fracture surgery is treatable, not something you have to “live with”.

The goal is to Preserve Your Joint, Not Rush to Replacement.

Need a consultation?

About Dr. Kashyap Prabhu Solanki & Dr. Prabhu Solanki

Orthopaedic Surgeon – Andheri, Mumbai

Dr. Kashyap Solanki specializes in hip and knee replacement, robotic-assisted knee surgery, and joint preservation procedures like HTO, arthroscopy, and ligament reconstruction. He is also known for performing complex revision joint replacements and managing challenging upper and lower limb fractures. With a focus on precision and patient-centered care, Dr. Solanki helps restore mobility and improve quality of life through advanced orthopaedic solutions.

With over four decades of distinguished orthopaedic practice, Dr. Prabhu Solanki stands as one of Mumbai’s most experienced and respected orthopaedic surgeons. Having treated more than 40,000 patients and performed over 10,000 surgeries, his clinical outcomes and dedication have earned him widespread recognition — not just in Mumbai, but across India and abroad.

Dr. Solanki’s reputation for precision, ethical care, and long-term results has brought him patients from all over India, as well as international patients seeking high-quality orthopaedic treatment and surgical expertise in Mumbai.

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