“It's Not My Knee”: Understanding Ongoing Pain and Discomfort After Total Knee Replacement Through Re‐Embodiment

Abstract

Objective. Up to 20% of people who undergo total knee replacement surgery have ongoing pain and discomfort. The aim of this study was to understand what role the concepts of embodiment (of both having a body and experiencing the world through one's body) and incorporation (integrating something into one's body) might have in understanding experiences of pain and discomfort after total knee replacement.Methods. We conducted semistructured interviews with 34 people who had received total knee replacement at either of 2 National Health Service hospitals in the UK, and who had chronic postsurgical pain (n = 34, ages 55-93 years). Data were audiorecorded, transcribed, and analyzed thematically.Results. Two main themes were identified: 1) when describing chronic postsurgical pain, some participants also described sensations of discomfort, including heaviness, numbness, pressure, and tightness associated with the prosthesis; 2) participants reported a lack of felt connection with and agency over their replaced knee, often describing it as alien or other, and lacked confidence in the knee.Conclusion. Participants' experiences indicate that some people do not achieve full incorporation of the prosthesis. Our study emphasizes the importance of physicians treating patients as whole people and moving beyond clinical and procedural ideas of success. Our findings suggest that to optimize postoperative outcomes, rehabilitation must focus not only on strengthening the joint and promoting full recovery to tasks but on modifying a person's relationship to the new joint and managing sensations of otherness to achieve full incorporation of the joint or re-embodiment.The views expressed herein are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Artificial Intelligence Discriminating Back Pain vs Hip/Knee Osteoarthritis within the Digital Affective Collective Consciousness

“…Chronic pain despite joint replacement is not uncommon, affecting approximately 10% of patients after total hip replacement and 20% of patients after total knee replacement (Wylde, 2015). The related emotion reported in literature is fear (Unver, 2014), altogether with withdrawal and depression (Moore, 2022). Psychological and structural factors interact exacerbating pain perception (Pan, 2018, Nwanko 2021).…”

Machine learning algorithms distinguish discrete digital emotional fingerprints for web pages related to back pain

“…Chronic pain despite joint replacement is not uncommon, affecting approximately 10% of patients after total hip replacement and 20% of patients after total knee replacement 34 . The related emotion reported in scientific literature is fear 14 , altogether with withdrawal and depression 15 . Psychological and structural factors interact exacerbating pain perception 16 , 17 .…”

“…Specific emotional patterns emerged to relate to different musculoskeletal degenerative diseases [9][10][11][12][13][14][15][16][17] ; the emotional content of external sources of information can complement rather than mirror users' , in a nonstraightforward complex system, in analogy with the counterintuitive role of sadness in the pleasure elicited by OPEN 1 Humanitas Gradenigo Hospital, Turin, Italy. 2 Imparamare Ong, Asti, Italy.…”

Perception of Heaviness Induced by Sensorimotor Incongruence Is Associated with Pain Prognosis: A Pilot Study

“…Patients with chronic musculoskeletal pain sufer from not only pain but also abnormal body perception [1][2][3][4][5][6][7][8]. A previous study reported that cast immobilization immediately after a fracture or tissue injury caused abnormal body perception in addition to limiting physical function, such as joint contracture and muscle weakness [9].…”

“…Tis abnormal perception has been described by patients in clinical settings in various ways, such as "it does not feel like my hand," and "I feel uncomfortable or strange about my hand" [10]. In several other studies, Patients with chronic musculoskeletal pain described their experience in the following ways: "I feel like my body is lead," "I feel like my body is constricted," "I feel like my body is swollen," and "I feel discomfort in my body" [1,8,11,12]. Such abnormal perception is thought to be caused by incongruence between motor intentions and sensory feedback [13][14][15][16].…”