Knee Pain after Hip Surgery: Causes, Solutions

By Lorra Garrick | Last updated 04/23

A physician cites three possible causes of knee pain following hip replacement surgery.

“Knee pain after hip surgery is a poorly-understood phenomenon,” says Devin B. Peck, MD, owner of Austin Interventional Pain in Austin, TX.

“A small retrospective study examined 13 patients who’d had hip replacement,” continues Dr. Peck. “Eight of the patients reported knee pain after the surgery.”

Three Possible Causes of Knee Pain after Hip Replacement Surgery

Dr. Peck explains, “Biomechanical measurements before and at six weeks after surgery [in the aforementioned study] did not demonstrate significant differences.

“Reasons for this phenomenon remain unclear, but may include changes in gait and leg length, and elimination of a greater pain-generator (hip), leading to more noticeable discomfort in the knee.

“Patients with severe hip osteoarthritis may develop a gait abnormality, known as Trendelenburg gait, due to weakness in the hip abductor muscles.

“This gait can lead to uneven pressures across the knee joint, and resulting arthritis in that joint.”

Solutions to Knee Pain Following a Total Hip Replacement Surgery

“The best way to optimize outcome after any joint surgery is to optimize preoperative conditioning,” says Dr. Peck.

This means “participation and compliance with a formal PT program along with home exercises (very important!).”

If the patient has excess body weight, then losing this weight will also help relieve some of the pain, since the knee, being the most unstable joint in the entire body, is very sensitive to excess body fat.

Hence, even a 10 percent weight loss will yield some improvement in the way this joint feels.

The patient may believe that fat loss is impossible due to limitations in the ability to use the lower body.

However, upper body strength training exercises will facilitate fat loss.