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Knee pain after total hip replacement

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Posted 8/29/2012 1:42 PM (GMT 0)

I had a total hip replacement in May 2012.  Everything was going great, my recovery took a little longer than expected, due to such major damage. When I started to walk again my knee on same side as hip replacement, started giving me severe pain.

My doc took x-rays said I have arthritis in my knee, gave me cortisone shot in my knee and put me on methylpredisolone for inflammation.

None of this has made a difference and I am still in a lot of pain.  

I looked at info on internet and found that some people have a lot of knee pain after hip replacement surgery. 

Has anyone had this problem?  Can't really walk for any length of time and am very upset at this turn of events since I thought the  hip replacement was going to do it for me.  I am only 54 yrs old.  Thanks for your thoughts.    Linda 

Posted 9/17/2012 9:22 PM (GMT 0)
No, I do not have arthritis in my  hands yet.  Also, I was anemic, so I don't think I have this problem, but thanks for your input.
Posted 9/26/2012 7:54 PM (GMT 0)
I had a right hip replacement on August 20th. My right knee began to be painful about 3 weeks after the surgery as I got more active. The physiotherapist who is doing my home visits says that it is quite common, especially if the knee has issues already. My problem was that for a year I was walking with my right toes turned inward to protect my hip. My knee had a strange weight put on it, and the muscles were moved differently from how they should be. Now that the hip is fixed I have to retrain all the muscles to walk properly aligned. I have been working on exercises to strengthen the muscles around my hip and to walk properly. After 5 1/2 weeks the knee pain is beginning to ease a little, but I think it is really important to keep walking and exercising to get everything strong again. Hopefully your knee will adjust. Maybe the cortisone shot did not hit the right place. My step dad gets those shots and sometimes they miss the sore bit, and it doesn't work.

How is the hip doing? I was hoping for a bit more flexibility by now, but my surgeon says I will have to wait 3 months to get the kind of movement I want. I was also hoping for the pain to be gone by now, but I still have some as well as tenderness in the incision. How about you after 4 months?
Posted 10/9/2012 4:18 AM (GMT 0)
I had partial hip replacement (femur head implant, no socket) on 6 August after a failed attempt to screw the head of the femur back on. After the surgery I had a lot of pain in my knee. The doc said that it was due to atrophy of the quadracep muscle because I had not used the leg in 2 months. He recommended that I do leg lifts sitting on a table with weight suspended from my ankle. I am now doing 300 lifts a day with 4.5 killograms. The pain in the knee is getting better. Also my leg is now about 1.5 centimeters shorter so I have added a lift to the bottom of my shoe and sandle. Since doing that it seems to have also helped the pain and also reduced the pain that I was experiencing in my lower back.

It's now 2 months after the surgery, I am able to walk without a cane, and don't not limp much. I can drive, pushing the clutch with no problems but still experience sharp pain in the upper quadracep if I twist the leg suddenly. I live in the "sticks" in central Thailand so there is not a lot of medical attention avaialble nor any physical therapy, but at least I am walking.

Post Edited (wayned) : 10/9/2012 2:03:16 AM (GMT-6)

Posted 10/9/2012 12:10 PM (GMT 0)
Great tips, wayned! Welcome to the forum and thank you for sharing this with others. It makes great sense to me.
Posted 3/19/2013 4:32 PM (GMT 0)
Belle1989 - I know it's been a while since you posted but I am wondering if you still have knee pain now. I had THR jan 20 2012 and although I had no knee pain before the operation I now have knee pain constantly and no one has been able to tell me why. An MRI showed little wear and tear and numerous doctors have told me there's no reason they can see why I have such pain in my knee. I am beginning to think the damage was done during the operation while inserting the new joint. I am so depressed that I just switched one pain for another and have to continue the meds I took for hip pain. Am looking to see if there is a more sophisticated MRI machine that might show damage to nerves in the knee.....my surgeon says it's due to the way I'm walking but I'm not buying that anymore.
Posted 3/24/2013 4:15 PM (GMT 0)
I had both hips replaced,sept and dec of 2012 and no pain in hips at all but knees very painful when I kneel down,I figured it was muscle wasteage from not doing this for so long so am trying to build up as need to do this for work.All comments on here have been very helpful,after it took me longer to register and access the site than it has done to get a credit card in the past,which was frustrating.Im onlu 46 so hope to get fully fit etc soon
Posted 5/2/2013 2:50 PM (GMT 0)
Hello. I'm new on this forum. I had a THR Anterior approach done 4 weeks ago. Was doing great. Walked with a cane 48 hrs after surgery & around the house for 3 weeks without a cane. Yesterday I suddenly almost had my knee almost collapse in pain on operated side. Prior to surgery like one of the posters I walked with my foot turned inward to protect the damaged hip for about 6 months. Very happy with the surgery but (darn) now back to a walker. I called surgeons office & was told this happens often in patients who waited a long time to have surgery done. I'm icing knee & still trying to walk through the pain & doing exercises to help. I would appreciate any input from others who have had this happen. Thanks.
Posted 5/15/2013 6:29 PM (GMT 0)
Hello. I am new to this forum as well. I had bilateral hip replacement at the end of November, and was doing very well -- even going to Europe and sight-seeing with no problem. Finally got off the cane 2 months ago. Then, about 3 weeks ago, I started getting some lower back and knee pain on the left (the worst) side and then one day my knee almost collapsed and I was in such pain that I almost called the EMTs. I immediately made an appt with my surgeon but, curiously, within 48 hrs, the pain was gone. I kept the appt with my surgeon and, since I also have a slightly slipped vertebrae that had responded well to shots 2 years ago, my surgeon thinks it isn't the hip that causing the pain, but rather the vertebrae pinching a nerve in my back. Yesterday, I went and had a nerve block at the pain management clinic, but it's not helping, although I will give it a couple of weeks. I am intrigued by all the comments on this "knee pain" thread. I do not have as much pain when using a cane, but I was hoping that I was done with using the cane. I will try the lift in the left shoe, because that definitely could be a problem. Thank you all for comments.
Posted 6/13/2013 1:52 AM (GMT 0)
Hello I'm a 35 year old male and just had a hip replacement .
Before my surgery was was experiencing knee pain I think due to having a bum hip. Well it's been two month since the surgery , while my hip feels better my knee pain has gotten worse . Is anyone out there going thru what I'm feeling?
Posted 6/14/2013 4:19 AM (GMT 0)
hi all,

even i was facing d same problem after my hip replacement, pain in my knee was so sever i was not able to walk properly. I was on Glucosamine medication, but it didn't help me in any way. Then i tried a new treatment, SPMF therapy in SBF healthcare for 21 days, during the treatment i felt much better. now its been 11 months after the treatment i feel better without any pain and able to walk small distance.
Posted 6/14/2013 2:46 PM (GMT 0)
I had a left anterior total hip replacement in June of 2012 up north. No problems whatsoever, doc said was his poster child. Still no problems on left.

Had my right hip done, anterior, early March 2013 after relocating to NC highly recommended surgeon. Saw him yesterday at the 3 month mark because the pain in my right knee and the muscle just above the knee and down the side of the knee about 3 inches is unbearable when I stand after sitting for about 15/20 minutes, and I have to grab the cane to simply walk the first few steps. After walking a bit, I can give up the cane, but still "wobbly". I cannot balance only on the right leg. I cannot raise the right leg more than about 10" from a laying position. Never had that problem with the left leg, could raise it straight up after only 5 or 6 weeks.

So yesterday, doc took an x-ray of the knee, said nothing wrong with the knee. He thinks that it is possible that the implant has not totally "knitted" with the bone and that I should use the cane, take Tylenol Arth. Tabs, 4 a day, and do a lot of walking.

I'm concerned because I'm over 3 months out on this now, and I have lost a lot of confidence in this doc. 4 other people I know have had the same surgery right here in my community, and they have no problem. But it is their first THR, not their 2nd.

Geesh ! :)

Thx for any encouragement or opinions.

Post Edited (LibbyWNC) : 6/14/2013 8:50:01 AM (GMT-6)

Posted 6/16/2013 3:51 AM (GMT 0)
I have the answer! I have had juvenile rheumatoid arthritis since I was 3 and Nurse for >20 of them. I have osteoarthritis n FMS as u can imagine. I had my left hip done. Besides when they fix you it often can shift ur gait. The blood from the hip settles in your knee and ankle often. So, if ur lower joints have any abnormality... The extra pressure hurts. All surgeries take a whole year to get back to baseline. But, if a person is not doing muscle strengthening( not walking only). Good luck. Believe me.. Too much can hurt but too little hurts worse! Good luck!
Posted 6/16/2013 9:27 PM (GMT 0)
Thank you Nurse1stick.   There are some "new" visible veins around the knee joint that weren't there before, and also near my ankle which was swollen for quite some time.    So I wonder why the ortho surgeon "thinks" that the bone has not sufficiently adhered to the implant yet?   Also, I had a full course of physical therapy, and have been going to PT maintenance for muscle strengthening on my own (unsupervised but the same machines) but didn't feel that was working out.    Now that our swimming pool is open, I'm thinking of doing my exercises in the pool and some low level swimming.   What about an MRI?  would that show anything abnormal?  Xrays only show bones.

Am also considering getting a second opinion from another ortho surgeon in a larger city.  I am in rural western NC.     

Posted 6/18/2013 4:46 PM (GMT 0)
Brand new to this forum!

A lot of these posts sound so familiar. I had THR, anterior approach, 5 weeks ago. Day surgery, home by 4 pm, no post surgical pain, going pretty smoothly. Day 4 after surgery, I developed a good deal of thigh pain, but was assured this was just reaction from post surgical trauma. My surgeon had told me 2 weeks crutches, 2 weeks cane, and I was anxious. Tried going from crutches to cane after about 5 or 6 days after surgery, but realized that was too soon.

At about the 2 week mark, I really had no hip discomfort, was managing swelling very well, I thought, but really hadn't elevated much. My thigh pain had dissipated but had knee pain which made it hard to walk without a cane, or crutches. Had enough good days, though, so that I could go for walks with no cane or crutch.

Now I'm 5 weeks and my knee pain is tough each day. Advil helps a lot and usually gives me a few hours where I feel almost completely normal walking (without and canes etc) but other times, I'm using 2 crutches and really hurting.

I'm elevating and icing religiously.

Am going to physical therapy and if an exercise hurts, I stop doing it.

I had x rays of my knee before surgery as I was hobbling around on my pre surgical hip, and the x rays showed no arthritis. I'm 98% sure there's no structural issues with the knee.

Pre surgery, I did some physical therapy where they had me re 'learning' proper walking, and I think I'm doing proper heal toe gait now, but my pain persists.

Hope I'm just jumping the gun, as alas, I am only 5 weeks.

Thanks for reading,

Kay
Posted 6/18/2013 5:25 PM (GMT 0)
Well, this is interesting. I had knee pain PRIOR to bilateral hip replacements. It was deferred pain from the hips. My hip replacements were due to osteonecrosis, not arthritis. I had the left one done in Nov. 2002. By Dec., the cup had slipped out of place, so I had a revision and woke up in a spica cast with a bar between my thighs. I remained in that for 3 wks., then was switched to locked steel hip and legs braces for 5 wks., so still immobilized. From that, I went to a wheelchair. Then to crutches, walker, cane. My insurance did not cover inpatient rehab, and it was difficult to get to hospital OP PT, so I got little therapy. The rt. hip was done in July 2003, with fewer complications, but both hips started dislocating within 6 mos. post replacement. I couldn't sit long enough to continue working, so applied for SSD. The surgeries were done at a teaching hospital, which accepted patients w/o insurance.

It took 2 yrs. to be approved for SSD, but I got Medicare at the same time. So off to Mayo I went.

I had gone to Mayo for liver cancer. So I had a great ortho surgeon there do revisions of both hips and I've had no problems since. I went to inpatient rehab both times, the first time for 10 days and the 2nd time for 2 wks. I can't stress how important this was. I also continued the exercises at home for 6 mos. afterwards. I have not had knee pain at all, until just the past 6 mos. I had x-rays taken and again saw the ortho doc at Mayo (I get everything done there now.) He said I had torn cartilage and arthritis on the lateral side of my rt. knee. I am not supposed to take ibuprofen, but when the pain gets too bad I break down and take 2 tablets...never more than that and only occasionally. I think I can get a partial knee replacement, but am holding off on that.

Nurse1stick was correct about it taking a full year to recover from hip replacement and revision. Be patient and continue to do your specific exercises for strength and ROM, preferably twice a day. It makes a huge difference.

Bless you all. It's no picnic.

Hugs,
Connie
Posted 6/18/2013 7:07 PM (GMT 0)
Kay, have you been back to the surgeon for your 30 day post-op appointment ? First though, I am absolutely amazed that you had "day surgery" for a THR. That seems so reckless to me. (Sorry, not knocking your surgeon, but that is unheard of.) 3- overnights in the hospital is standard. It's not like a tonsillectomy!

Anyhow.... if you are at 5 wks. you should expect the thigh numbness and some nerve pain in the thigh for quite awhile. It will come and go. They don't cut muscles with the anterior approach, but they do stretch and move them around, maneuver them out of the way with instruments. It is traumatic to the nerve endings and the muscles. Physical therapy at home is crucial; and then out patient physical therapy thereafter for as long as your ins. will pay for it.

The total recovery period I'm told by both surgeons (the one in New England and the one here in NC) is to expect a 6 to 12 month period for recovery. Depends a lot on your weight, general condition, and the severity of the bone on bone or necrosis of the hip joint.

Neither surgeon that I had would ever do a bilateral. I trust the New England doc 200% more than the one here. The hospital and the surgeon make all the difference. In my case, I'm seeing doc again in early August and might get a second opinion in the meantime; or if I'm still hurting after August, I will definitely get a second op. then.

But Kay, call or get to your doc if you are having that much pain.
Posted 6/19/2013 12:12 AM (GMT 0)
I agree with Libby on all counts. I had tremendous pain after that first hip replacement, and the doctor's answer (on the phone) was to increase my Percocet. That really didn't help much. When I went in for my first check-up and x-rays were taken, that's when the slipped cup was noted. They admitted me on the spot. So don't wait...get in to see your surgeon.

Hugs,
Connie
Posted 6/19/2013 12:34 AM (GMT 0)
I'm going to see the surgeon next week for my 6 week check in. At 2 weeks, the first prescribed by him, he told me that crabs - leg exercises - were good, and I'm afraid that I relied on my physical therapist for exercise, so I didn't do much at home.

Regarding day surgery ... my doc is chief of adult reconstruction at Lenox Hill in NY and also has OR privileges at Special Surgery. He thought the day surgery would be a good alternative vs the the hospital environment and we opted for that. I really can't see what a hospital stay would have done for me. I felt great leaving the surgical facility.

For the life of me, I can't see any reason for going through the requisite 2-3 hospital experience. My first night home I didn't sleep very well, but after that, no problems. I was off percoset and oxycontan (sp?) after 48 hours. After that, just Celebrex and tylenol. The hospital certainly was not the issue.

I think that I have not taken the exercise part of my rehap seriously enough. As I research it, it really looks like it is IT Band Syndrome. My pain is on the outside of the knee, and just below the knee on the upper part of my lower leg.

Now making sure my exercise routine includes a few sessions of the 3 easy IT Band exercises, which seemed so trivial, I guess I didn't take them seriously.

I'll keep you posted, but just Google IT Band Syndrome, and you'll find my symptoms.

But as Connie pointed out above, I must take my exercises more seriously.

Kay
Posted 6/19/2013 12:46 AM (GMT 0)
Hi Kay, yes I'll look up the IT Band Syndrome because that is pretty much where mine is painful as well. Just a few inches on my thigh above the right knee, and a bit down the outside of the knee, same description. The PTherapy exercises at home the first weeks are crucial and it is so easy to lay off those when you're hurting, but they really get your recovery started off on "the right foot". :) I also had a lot of PTherapy as an outpatient, and heated pool therapy which felt wonderful. But nothing thus far is helping this knee thing. Having such an awesome result with the left hip has spoiled me for what is going on now with the right side.

Please get back to us after you see your doc Kay, it will be helpful to hear what he says. (I am only taking 2 Tylenol arth.form. twice a day and it does seem to help. According to my daughter who is an O.R. nurse, she said Tylenol "switches off the pain sensors" in the brain, it's a false sense of security. Oh well. Whatever helps. I have some Tramadol, but don't like to take meds.)
Posted 6/19/2013 1:24 AM (GMT 0)
I'll keep you posted Libby. I intend to take my exercises far more seriously, as this knee pain is just as debilitating as my pre surgical hip.

I think I said the 'crab' exercises, I meant clams. 4 letter fish, you know.

Kay
Posted 6/25/2013 8:20 PM (GMT 0)
I saw my surgeon today and asked what he thought my knee pain was all about. He said that my IT Band was tight, and also my quadricep was tight as well. This is consistent with what my physical therapist has said.

I am gradually feeling better as my quad, hamstring, glute, and piriformis get stronger. My doctor assures me that it will get better, but I need to continue to work on the supporting muscles.

Kay
Posted 8/9/2013 8:16 AM (GMT 0)
After reading everyone's posts I am getting the impression that even though I had my surgery June 25 I still have a long recovery time to sadly in my future. I too am having a lot of knee pain and weakness, at times it feels like it is going to buckle in me! The Dr did X-rays of my knee and it is healthy, so he has ordered an MRI for tomorrow, what could this possibly show? I am very depressed about the slow progress I am making, I expected to be back to work by now and I still can't walk by myself.
Can anyone give me some advise? What if my knee was damaged during the surgery, no prior problems. If it was damaged what happens now?
Oh and I was wondering if I need some kind of verification when traveling, will this ceramic hip set off metal detectors at the airport?
Posted 8/28/2013 2:25 PM (GMT 0)
Okay I had my MRI on my knee just a little arthritis. Can any one suggest some good exercises to do to help my knee and not interfer with my AHR? I am 8 weeks out and still have a lot of knee and thigh pain and sometimes a little zap at the top of the leg when I get up after sitting for 15-20 minutes. I have run out of PT visits. I am using a cane, but walking with out it is very wobbley.

Again has anyone had any problems with going thru metal decters at the airport? What do you say when your hip sets it off???
Help Please, i live alone and have had very little help during my recovery, so I need to get myself strong as soon as I can.
Posted 9/5/2013 6:19 PM (GMT 0)

This may sound crazy but I suggest knee-pain suffers find an Eastern (Chinese or Japanese) chiropractor who incorporates work on your feet.  You’re looking for someone who applies pressure to your soles, heels, outside calf, inside thigh, outside thigh (adjacent to hip), and even right side of abdomen. 

 

I’m 57, male, avid cyclist.  Nine months ago I had THR (right side, anterior procedure).  I was pain-free after the surgery.  I completed physical therapy exercises while I reduced my exercise routine to nearly nothing.  No more 100 – 150 miles per week on the bike.  I was resigned to not wanting to wear out my new hip joint too quickly.

 

A month ago, after walking briskly through long terminals at the airport, my knee was so painful I couldn’t put weight on it.  My orthopedic surgeon took another X-ray and said everything looked good.  I enrolled in physical therapy again – the PT said my issue sounded “nervy” and that he didn’t know how to help me after watching me walk on a treadmill (almost pain-free).  So, I returned home, climbed on the stationary bike and spun for 30 minutes.  Big mistake.  I couldn’t walk w/o a cane.  I went to a “regular” chiropractor after that – no help. 

 

A few days ago I visited a chiropractor who incorporated Eastern philosophy into his practice, which is way of saying he did things that made no sense when measured on the scale of Western medicine.  He applied pointed pressure to my right foot and at points on the right side of my body.  VERY focused and intense finger pressure. 

 

When I left his office I forgot my cane.  I still “felt” my knee.  Yes, it was weak.  But it didn’t collapse under my 177 lbs.    

 

Now, when I walk, I’m aware of micro-adjustments I was making (since original post-surgery PT?) while walking.  I work on posture.  Sometimes when starting to walk I still “feel” my knee but I am able to walk w/o pain.  I believe my original hip degeneration caused my body to compensate in ways of which I wasn’t aware, and that those minor corrections, cumulatively, manifested in my sudden debilitating knee pain and pelvis that was slightly torqued to one side.   

 

I see my “Eastern chiropractor” again in two weeks.  He’ll work on the other side of my body.  In the meant time he wants me walking barefoot when possible, and in sand if possible.   

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