GoutPal Interactive

Post edited 1:11 pm – May 10, 2009 by GoutPal

I started this topic following a comment on my post about the signs and symptoms of gout. RP says:

… I went to hospital and was diagnosed with gout and had a steroid injection and my knee subsided and the pain went. …I had the total knee replacement and have suffered considerable post operative pain which I would imagine is normal but nearly a month later my knee is still badly swollen and I cannot sleep with the pain. Could this be because of a recurrence of gout and what can I take to help it. Could it effect or damage the knee replacement ? RP

The steroid injection is a very effective way to get rid of gout pain in the short term, however it does absolutely nothing to fix gout in the long term, which can only be done by lowering uric acid below 6mg/dL. First step is to see a rheumatologist to confirm that you actually suffer from gout. It is commonly confused with pseudo gout or septic arthritis, and a rheumatologist is definitely the best person to diagnose this correctly. If it is gout, then there is a risk that the surgery will make the gout worse. I’m not clear about how gout might affect the replacement joint. A 2005 gout and replacement joints study [Ed: Link no longer valid - see DOI 10.1046/j.1460-9584.2002.00337.x] reports:

Gout is known to occur occasionally at the site of trauma and has been reported in association with hip and knee replacement. The initial presentation is similar to that of an infected joint and may be associated with loosening. … Why gout should initially present at the site of arthroplasty [joint replacement] is not known; however, it is possible that the abnormal tissue surrounding the joint replacement allows the build-up of urate crystals at a time when the gout is still in its subclinical phase.

The rheumatologist can advise you about the risks associated with damage to your knee, and how to reduce them.