Severe Knee Pain after Total Hip Replacement Surgery

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New Member

Date Joined Aug 2013
Total Posts : 1
   Posted 8/11/2013 9:24 AM (GMT -7)   
Had a THR in May and was progressing well until I started having severe knee pain (on the same side as THR).  X-rays show no damage to knee but knee pain persist.  Surgeon states it's unrelated to THR but I'm not buying that. It is now 13 weeks after surgery and must use cane to walk and knee pain is severe and hurts every time I take a step. Ant thoughts ?

Regular Member

Date Joined Jun 2013
Total Posts : 257
   Posted 8/11/2013 11:15 AM (GMT -7)   
Welcome TwoVillagers,

We aren't doctors here and can't effectively provide a true diagnosis we can only provide support and guesses from personal experiences... BUT as a layman's guess I would say its either your meniscus or your acl. You will need to get an MRI to check for cartilage and other soft tissue damage. You can injure you meniscus by just a twist of the knee and since you are now putting more stress on the knee to compensate for the THR it wouldn't be to much of a stretch to have soft tissue damage. If its not the meniscus [which would be my first guess with a wheel spoke tear which I have had and they hurt. Because a pan handle causes your knee to lock up] I would think you over stretched and possibly caused a mild tear, severe strain/sprain to the ACL.
But if you aren't having much in the way of swelling I would lean more towards the meniscus injury. Either way you need an MRI or CT scan to see in there because an X-ray only shows bone and doctors seem to think that they can stop at an X-ray.

Another way you can do an at home test is sit on the edge of the bed, couch, ect and swing your leg out slowly from the knee. Does that hurt at the knee? I had the doctor press my knee and twist it around to see if it hurt and if there was any catching, clicking, or slipping when I had my knee injury. That was what he had me do. I am not saying have someone twist the knee who isn't a medical professional because you are injured and I don't want to see you get hurt more. Just support your hip and try to swing at the knee all the way up and see if that causes pain at the knee joint.

I would push for you to go to the doctor and request soft tissue imaging. I don't know what kind/type of hard ware they put into you so an MRI might not work but you should be able to get some kind of soft tissue scan for a diagnosis.

Best of luck
Crushed right meniscus, psvt tachycardia, ventricular tachycardia, L4-L5 bulging disc with tearing, pinched sciatic nerve left and right. L5-S1 disc gone bone remodeling with bone spur pressing on spinal cord. [Recommended spinal fusion] Modic type 2.


If pain is weakness leaving the body then I must be a strong woman by now.

Forum Moderator

Date Joined Jul 2013
Total Posts : 4771
   Posted 8/11/2013 12:11 PM (GMT -7)   
Let me share my experience. Both my left and more recently my right, have total hip replacements. And it's been my experience knee pain is absolutely a part of it. My surgeon made that very clear. I had severe knee pain both before AND after THR's.

In both cases, an aspect is body mechanics. A thought is to bring this up to your physical therapist because you may have not yet learned to alter your ambulation and gait to accommodate this new prosthesis. Absolutely this will stress your knee. Not even a question!

The knee pain went away on my left (my first THR), and as for my recent one, the right hip, which was done on 6/10/13, I had knee pain before, and I still have it now, BUT, I know from experience what it's from so I'm not freaking out or thinking something's wrong.

That's me, my experience, my personal process.

If your diagnostics show the hardware is sound, them I'd work with PT to check your gait. Makes a massive difference.

Good luck to you.


Regular Member

Date Joined Mar 2013
Total Posts : 67
   Posted 8/11/2013 3:16 PM (GMT -7)   
I agree with sookie
I had my left hip replacement done 22 yrs ago and it's still going strong  . but putting the new hip in completely changed my gait I had limped so bad for so long before the hip replacement . that when they adjusted my leg length witht he new hip something had to give . in my case it was my knee. I had a few knee clean outs before having a total knee reconstruction that fixed the problem I haven't had knee problems for many yrs now .
lower back probs sure it hurts all the time but the knee is pretty stable so it def can be a by product of the hip surgery for sure .
cheers dean

New Member

Date Joined Feb 2017
Total Posts : 1
   Posted 2/10/2017 12:15 PM (GMT -7)   
Had my left anterior thr in April 2015, right anterior thr November 2016. Now, I did have knee pain after the left thr but it didn't last that long and was manageable with anti inflammatory meds. However, since the day I had the right thr I have had bad knee pain and unfortunately I can no longer take anti inflammatory meds because of kidney disease. I returned to my surgeon who ordered X-rays. These showed nothing abnormal but because of my chronic knee pain she gave me an injection of Novocain and Cortisone. I felt immediate relief however, it did not last for any amount of time. Back to the surgeon a few weeks later and she ordered an MRI. The rusults of the MRI show I have a tear of the anterior horn and body of the lateral meniscus. I have no doubt this injury occurred as a result of the surgery and the technique used to manipulate the leg during the procedure. Now I am waiting for her to refer me to a knee specialist to see what my options are. Anyway, my point being is this. So many people who have had thr end up having knee issues. If the surgeons were to get a better handle on this they might be a little more aware of how to prevent them. By all means don't be satisfied with just an X-ray which will not show these types of injuries. Had she not ordered an MRI I would have demanded it. Wish you all luck and good health!

New Member

Date Joined Mar 2017
Total Posts : 2
   Posted 3/31/2017 7:56 AM (GMT -7)   
Hi Im a new member, read through all the older posts and am surprised (and comforted somewhat) to see so many people with the same issues. So its not just me,and I didn't so something wrong good to know...

I did have knee problems before due to arthritis but they cleared up considerably until I fell and broke my hip a year ago. At that time they repaired the hip. Things went down hill after I was diagnosed with avascular narcosis in January. I am 2 weeks out of surgery for total hip replacement (right hip,anterior). Did absolutely great the first week, feeling like my old self again. Then started having the same knee issues everyone here has. I get that this is 'normal' and that there are many reasons for the knee to be hurting so bad. But its gotten to the point that I have trouble walking, so am not walking my hip the way I should, and am not able to do many of the hip exercises because they hurt the knee. Been icing, elevating, resting - going for my post op next Thursday but in the meantime - how do I keep my hip exercises up without hurting my knee more? Are there things I can do that can be good for both? And is it ok to use a TENS unit on the knee?

Veteran Member

Date Joined Dec 2012
Total Posts : 680
   Posted 4/7/2017 7:41 PM (GMT -7)   
It has been a few days since you last posted and I just now noticed that no one has responded to your last query and check in.

It is not unusual for people to experience a gradual and consistent upward trajectory in their initial post-total joint replacement recovery for the first 1-2 weeks followed by a downward trending and backward steps. As the deeper muscles heal and as the bone scaffolding begins to reshape and remodel, it is typical for a person to feel more fatigued, more pained, and to struggle with daily activities including walking and standing tolerance. Inflammation of surrounding tissues

It is helpful to return to using a walker when the new joint replacement is aching or the contralateral leg/knee is aching and complaining. Taking weight through your arms in using a walker takes weight off of an aching and new hip joint.

Use cold packs over the new joint to ease pain and inflammation.

You can also continue with the isometric exercise portion of your home exercise program when the new hip joint or opposite knee is uncomfortable and complaining. Isometric exercises are those where you contract/tighten the targeted muscle, hold the muscle tight for a count of 30 seconds, then relax. You can also modify the positions of prescribed exercises to reduce
stress to one joint or another. Active hip ABDuction/ADDuction (moving the leg out to the side and back) can be done lying supine on your bed at home, rather than in a standing position.

Yes . . you can use a low-volt TNS unit on the knee with a hip replacement. Home TNS units utilize a low-wattage 9 volt battery pack. The electromagnetic field of a TNS unit will not adversely affect the tissue surrounding the new hip impact or the leg itself (a TNS unit does not heat body tissue).

Bottom Line: It is not unusual to experience a dip or lull in how you feel during recovery.
- K -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)
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