# Persistent Pain due to Cement Protrusion After Total Knee Arthroplasty: A Report of Three Cases

## TL;DR

This paper reports three cases where persistent knee pain after knee replacement surgery was caused by cement protrusion and resolved with arthroscopic removal.

## Contribution

The study identifies cement protrusion as a novel cause of persistent lateral knee pain after total knee arthroplasty.

## Key findings

- Chronic lateral knee pain after surgery was linked to cement protrusion at the lateral femoral interface.
- Arthroscopic cement excision effectively resolved the pain in the reported cases.
- Passive full knee extension during cement curing may lead to cement extrusion.

## Abstract

Chronic lateral knee pain after uneventful total knee arthroplasty can be challenging to manage. We present 3 cases where the pain transiently resolved with injections of local anesthetic. Diagnostic arthroscopy revealed cement protrusion at the lateral femoral bone-prosthesis interface. Passive full knee extension during the curing phase is routine to ensure cement pressurization and optimal bonding. This may enable cement extrusion at the lateral femoral interface and result in persistent pain. Therefore, prevention measures should include thorough visualization of the implant after cementing. Arthroscopic cement excision en bloc is a minimally invasive procedure to treat these patients.