Is Knee Pain Normal After Hip Replacement Surgery?

Hip and knee health

Hip replacement surgery is designed to relieve chronic hip pain, restore mobility, and help patients return to the activities they enjoy. However, during recovery, some patients experience an unexpected symptom: knee pain after hip replacement surgery.

If your knee hurts after having your hip replaced, it does not necessarily mean there is a problem with your knee or your new hip. The hip, knee, muscles, nerves, and surrounding tissues all work together when you stand and walk. Changes in one area can temporarily affect another.

At Great Lakes Orthopaedics in Garden City, Michigan, our orthopedic specialists provide comprehensive care for patients experiencing hip, knee, and joint pain. Understanding why knee pain can occur after hip replacement is an important part of knowing what to expect during recovery.

Is Knee Pain Normal After Hip Replacement Surgery?

Some knee discomfort can occur during the recovery period following a total hip replacement. Your body has to adjust to changes in mobility, muscle strength, alignment, and walking mechanics.

Before surgery, chronic hip pain may have caused you to limp or place more weight on one side of your body. Once the damaged hip joint is replaced, your muscles and joints need time to adapt to a healthier walking pattern.

As strength and mobility improve, recovery-related knee discomfort may also improve. However, persistent, severe, or worsening knee pain should always be discussed with your orthopedic provider.

What Causes Knee Pain After Hip Replacement Surgery?

There are several potential reasons your knee may hurt following hip replacement surgery.

1. Changes in the Way You Walk

One of the most common causes of knee pain after hip replacement is a change in your gait, or walking pattern.

Patients with severe hip arthritis often change how they walk to compensate for pain. You may have limped, shortened your stride, shifted your weight to one side, or relied more heavily on your opposite leg.

After hip replacement, your body needs time to relearn a more natural walking pattern. During this transition, the knee may experience different stresses than it did before surgery.

Physical therapy and rehabilitation can help improve your walking mechanics as your hip becomes stronger.

2. Muscle Weakness After Surgery

Your hip doesn’t work independently from the rest of your leg. The glutes, quadriceps, hamstrings, hip stabilizers, and other muscles all contribute to lower-body movement.

Following surgery, temporary muscle weakness can change how forces are distributed through the hip and knee.

Weakness involving the muscles surrounding the hip may cause the knee to compensate for reduced stability. This is one reason strengthening exercises and physical therapy can be important components of hip replacement recovery.

3. Changes in Leg Length or Alignment

Some patients feel as though one leg is longer than the other following hip replacement surgery. In certain cases, there may also be an actual difference in leg length.

Changes in leg length or lower-body alignment can alter how pressure travels through the hip, knee, ankle, and foot.

Even subtle biomechanical changes may initially feel unfamiliar and contribute to discomfort while your body adapts.

If you notice a significant leg-length difference or feel uneven when standing or walking, speak with your orthopedic surgeon.

4. Referred Pain From the Hip

Sometimes the knee isn’t actually the source of the pain.

Referred pain occurs when discomfort originating in one part of the body is perceived somewhere else. Because the hip and knee share interconnected nerve pathways, irritation or inflammation around the hip can sometimes be experienced as pain around the thigh or knee.

This is also why orthopedic specialists may evaluate both the hip and knee when determining the source of lower-extremity pain.

5. Putting Extra Weight on the Opposite Knee

Knee pain doesn’t always occur on the same side as the hip replacement.

During the early stages of recovery, you may instinctively protect your surgical leg by shifting more weight onto the opposite side. That can increase the workload placed on the other knee.

If the opposite knee already has osteoarthritis, cartilage damage, or another condition, the increased stress may make symptoms more noticeable.

6. Pre-Existing Knee Arthritis

Hip and knee arthritis frequently affect mobility, and some patients have degeneration in more than one joint.

Before hip replacement, severe hip pain may have been your primary concern. Once that pain improves, an existing knee problem can become more noticeable.

Common symptoms of knee osteoarthritis include:

• Knee pain during activity
• Stiffness
• Swelling
• Reduced range of motion
• Difficulty walking or climbing stairs
• Grinding or clicking sensations

An orthopedic examination can help determine whether your knee discomfort is associated with hip replacement recovery or an independent knee condition.

7. Postoperative Inflammation

Inflammation is a natural part of the body’s healing response after surgery.

Changes involving muscles, tendons, ligaments, and other soft tissues around the hip and upper leg can contribute to temporary discomfort elsewhere in the leg.

As inflammation decreases and healing progresses, some patients notice their associated knee discomfort gradually improving as well.

8. Nerve Irritation

Nerves extending from the spine and hip region travel throughout the leg. Irritation involving these nerves can sometimes produce symptoms extending toward the thigh or knee.

Nerve-related discomfort may feel like:

• Burning
• Tingling
• Numbness
• Shooting pain
• Electric-like sensations

If these symptoms persist or worsen, an orthopedic evaluation can help identify the underlying cause.

How Long Does Knee Pain Last After Hip Replacement?

There is no single recovery timeline that applies to every patient.

If knee pain is caused by temporary muscle weakness, inflammation, or changes in walking mechanics, it may gradually improve as the hip heals and normal movement returns.

Factors that can influence recovery include your age, overall health, physical condition before surgery, severity of arthritis, type of hip replacement, rehabilitation progress, muscle strength, and other existing orthopedic conditions.

Great Lakes Orthopaedics emphasizes that recovery from total hip replacement takes time and may include physical therapy, pain management, strengthening, and learning safe ways to move during the healing process.

How Is Knee Pain After Hip Replacement Treated?

The appropriate treatment depends on why the knee hurts.

Your orthopedic provider may evaluate your hip, knee, walking mechanics, strength, range of motion, and alignment to determine the source of the discomfort.

Treatment may include:

Physical Therapy

Physical therapy can help strengthen the muscles supporting your hip and knee while improving balance and walking mechanics.

Your rehabilitation program may include exercises focused on:

• Hip strength
• Quadriceps and hamstring strength
• Balance
• Flexibility
• Range of motion
• Walking mechanics

Always follow the rehabilitation plan provided by your surgeon or physical therapist.

Gradually Increasing Activity

Doing too much too soon can place unnecessary stress on your recovering joints and muscles.

Walking and other activities should generally be increased according to the recovery plan established by your orthopedic team.

Using Assistive Devices Properly

Walkers and canes can help provide stability and reduce stress on the recovering leg.

Proper use is important because using an assistive device incorrectly can affect your gait. Follow your medical team’s instructions about when and how to use these devices.

When Should You Worry About Knee Pain After Hip Replacement?

Mild or temporary discomfort may be part of the recovery process, but certain symptoms deserve medical attention.

Contact your healthcare provider if you experience:

• Severe or increasing pain
• Significant swelling
• Increasing redness or warmth
• Fever
• Drainage from your surgical incision
• Increasing tenderness
• Difficulty bearing weight
• Sudden changes in mobility
• Persistent numbness or weakness

Symptoms such as chest pain or shortness of breath require urgent medical attention, as they can potentially indicate a serious postoperative complication.

Can Hip Problems Cause Knee Pain?

Yes. Hip conditions can sometimes cause pain that is felt around the knee.

The connection between the hip and knee is one reason determining the actual source of joint pain can require a comprehensive orthopedic evaluation. Treating only the area where pain is felt doesn’t necessarily address where the problem originates.

If you have unexplained knee pain along with hip stiffness, reduced mobility, or a history of hip problems, an orthopedic specialist can evaluate the entire lower extremity.

Hip Replacement Care at Great Lakes Orthopaedics

If you’re experiencing persistent knee pain following hip replacement surgery, Great Lakes Orthopaedics can help determine what may be contributing to your symptoms.

Our Garden City orthopedic practice provides specialized care for hip replacement, anterior hip replacement, knee treatment, total joint replacement, sports medicine, and general orthopedic conditions.

Great Lakes Orthopaedics has served the local community for more than 60 years, with orthopedic surgeons specializing in total hip and knee replacement and other advanced orthopedic procedures.

Our goal is to help patients understand their condition, explore appropriate treatment options, and safely work toward restoring mobility.

Frequently Asked Questions About Knee Pain After Hip Replacement

Schedule an Orthopedic Evaluation in Garden City, MI

Hip replacement recovery involves more than allowing the surgical site to heal. Your muscles, walking mechanics, and surrounding joints must also adapt to changes in the hip.

While knee pain after hip replacement surgery may sometimes be related to temporary changes during recovery, ongoing pain shouldn’t simply be ignored.

At Great Lakes Orthopaedics, our experienced orthopedic team provides personalized care for patients dealing with hip pain, knee pain, arthritis, joint replacement, and other musculoskeletal conditions.

If you’re concerned about knee pain after a hip replacement or want to discuss your hip or knee symptoms, contact Great Lakes Orthopaedics at (734) 422-8400 to schedule an appointment at our Garden City, Michigan office.

This article is for general educational purposes and does not replace medical advice. Follow your surgeon’s instructions and contact your care team about symptoms that concern you.