Why Hip Pain Occurs After Total Knee Replacement and How to Treat It

Understanding Hip Pain After Total Knee Replacement

Total knee replacement surgery is a common and effective solution for severe knee arthritis or injury, offering improved mobility and pain relief. However, some patients may experience a new discomfort: pain in the hip after total knee replacement. This issue can be surprising, especially if the hip felt fine before the procedure. Understanding why this occurs, and how it relates to biomechanics and post-surgical recovery, is key for effective management and peace of mind. Let’s explore why this happens and what you can do about it.

Causes of Hip Pain Following Knee Surgery

After knee replacement, the alignment and loading of your leg may change. As your new knee joint adjusts to proper alignment, your posture, walking pattern (gait), and body mechanics also adapt. These adjustments can place unexpected strain on the hip joint, especially if there were minor pre-existing conditions that were asymptomatic before surgery. Weak hip muscles or tendons, altered leg length, and increased activity during rehabilitation may contribute to discomfort. In some cases, the lower back or pelvis compensates for changes in gait, leading to referred pain in the hip area. Rarely, pain may signal an underlying issue such as inflammation, bursitis, or arthritis that has become noticeable only after the knee surgery.

Short-Term and Long-Term Complications to Watch For

Short-term hip pain after knee replacement is typically the result of muscular adjustment, soft tissue irritation, or inflammation. Most patients note improvement as the muscles and joints adapt during the healing period. Long-term hip pain may indicate underlying biomechanical issues, persistent arthritis, or problems with pelvic alignment. If hip pain is accompanied by swelling, redness, inability to bear weight, or progressive worsening, it’s important to contact your healthcare provider promptly. Ignoring persistent symptoms can lead to further joint dysfunction and limit your overall recovery from knee surgery.

Optimising Recovery and Rehabilitation for Hip Comfort

Rehabilitation after total knee replacement is crucial for successful recovery, not just for the knee but for the entire lower limb. A targeted physiotherapy programme that incorporates strengthening and stretching of the hip muscles, alongside core stability and balance exercises, can offer substantial relief. Attention should also be given to gradual gait retraining, correcting muscle imbalances, and ensuring your walking aids (if needed) are set correctly. Gentle low-impact exercise, such as swimming or cycling, helps keep the hip joint mobile without overstraining it. If pain persists beyond the expected recovery timeline, reassessment by your physiotherapist or orthopaedic surgeon is advised.

Tips for Preventing and Managing Hip Pain After Knee Replacement

While some discomfort is a normal part of recovery, you can take steps to minimise hip pain alongside your knee rehabilitation.

Follow your rehabilitation plan consistently, including home exercises for the hip and knee.
Pay attention to your walking pattern, trying to avoid limping and excessive compensation on the opposite leg.
Use assistive devices (walking frame or stick) as recommended until your gait is stable and symmetrical.
Monitor your posture and avoid long periods of sitting or standing in one position.
If pain worsens or changes character, seek early review to address potential complications.

When to Seek Medical Advice for Hip Pain

Post-surgical hip pain should gradually improve with appropriate therapy. However, contact your doctor or physiotherapist if you experience sudden, severe pain, swelling, inability to move the leg, or if you notice fever and redness, as these could indicate an infection or a more serious joint issue. Early intervention can prevent prolonged discomfort and support better long-term outcomes.

Frequently Asked Questions

Is hip pain after total knee replacement normal?

It can be quite common for some patients to experience temporary hip pain after a total knee replacement. This is usually due to changes in walking patterns, altered biomechanics, or increased activity during rehabilitation. Most cases of hip discomfort improve as your body adapts, but persistent or severe pain should be discussed with your healthcare provider.

How long does hip pain last after knee replacement surgery?

Hip pain often appears in the early weeks after surgery, coinciding with the active rehabilitation phase. Generally, with appropriate exercises and adjustments, the pain diminishes over a few weeks to months. If your symptoms persist beyond three months or worsen, further medical evaluation is advised.

What should I avoid if I have hip pain after knee surgery?

Avoid high-impact activities, excessive stair climbing, and sudden twisting movements until cleared by your physiotherapist. It’s also important not to ignore changes in your gait or posture; these can exacerbate both knee and hip discomfort and may delay recovery.

Can strengthening exercises help relieve post-surgical hip pain?

Absolutely. Strengthening the muscles around your hip and pelvis plays a significant role in stabilising your lower limb and improving gait. Your physiotherapist can recommend tailored exercises to target weak areas and support a smoother rehabilitation process.

Could hip pain after knee replacement mean something serious?

While hip pain is often benign and temporary, it can occasionally signal other issues such as hip arthritis, bursitis, nerve irritation, or compensation-related problems in your back or pelvis. Persistent, severe, or rapidly worsening pain should prompt a medical review to rule out complications.

Should I inform my surgeon or physiotherapist about hip discomfort?

Yes, always keep your healthcare team informed about any new or ongoing symptoms after your knee replacement, including hip pain. This helps ensure any underlying issues are addressed early, and your overall rehabilitation plan remains safe and effective.