THR Knee pain 1½ years after THR

FraidyCat

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Hi, all. I've not been on this site since around the time of my R THR in late October of 2016. Everything seemed to be going well postop -- and perhaps it still is. However, over just the last week I've had a new problem, and after doing some online research I have the unsettling suspicion that it may be related to the THR. Prior to THR, I had only mild, sporadic knee issues, mainly manifesting as a "heavy" feeling when climbing stairs. But suddenly, over the last five days, severe knee pain has developed, making it painful to bear weight when going up and down stairs (especially down) and when rising from a seated position.

Rheumatologist ordered x-rays, which showed mild-to-moderate "changes" (arthritic, I'm assuming) bilaterally but worse on the left side. However, the pain is mainly on the right -- i.e., the side that had the THR. I'm reading that it's not uncommon for people to have biomechanical issues affecting the knees and gait after THR. This is ironic, considering that the main reason I had THR, after five years of ruminating about it, was I felt the hip problem was affecting my gait; however, my hip pain was actually not as severe as the knee pain I'm now having.

Have others had this experience of new knee issues developing as long as 1.5 years after THR that didn't have an obvious explanation such as severe OA? If yes, how did the surgeon explain it and what treatment was recommended? Did the knee pain improve?

It seems massively discouraging to contemplate that I might have merely traded faulty hip biomechanics for altered knee biomechanics, accompanied by pain more debilitating than what I had in the first place with the hip.

Any input would be appreciated.
 

Josephine

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Hey FraidyCat - nice to hear from you!

If your knee pain is, by your reckoning, 'severe', then you need to do something about it. I've never found rheumatologists to be very savvy when it comes to arthritic joints. You haven't said so I must presume that you haven't yet seen a knee surgeon? If not, why not?

You could also print this off and fill it in. Then you could take it with you to the consultation - when you get one!
 

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FraidyCat

FraidyCat

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Thanks, @Josephine, for the response and the scorecard. I've now emailed the office of the surgeon who did my hip replacement (he also treats knees), describing my knee-pain onset and asking about being seen by him. I'm wondering if the knee pain might be related to altered biomechanics resulting from the hip surgery, since the x-rays showed only mild-to-moderate knee arthritis, mostly on the left, whereas most of my pain is on the right, which is the side that the hip surgery was done on.
 

Eman85

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Knee pain is tricky, can just be muscle pain. My knees would have a burning sensation above the knee cap. This is muscle many times caused by uphill and downhill walking.
 

GrannyC

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@FraidyCat I had THR (right) in April 2017. In early May this year I went for me one year check and all was well. I told PA i felt some weakness in my knees when doing stairs and a few other small issues with my knees and asked if they could do X-rays of my knees while I was there to save me a trip back. They obliged and the X-rays shows arthritis in both knees but worse (bone on bone) on right. I really don’t have any pain in my knees yet so definitely am not considering any surgery for now. If and when they really bother/hurt, then I consider the surgery. Actually PA said she knew for sure I had arthritis in both knees even before X-rays. I didn’t ask how she knew so I can only assume that it is common to have arthritis show up in other joints. I think you made a wise decision to see your OS and find out just what is going on with the knees. As you know, our joint conditions seem to be able to change almost overnight sometimes. Wishing you well. Keep us posted.
 

Layla

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Hi @FraidyCat
I have a similar story to GrannyC's. The knee on my op leg has been bothering me off and on since my THR.
Never bothered me before THR. Six months post op, had knees x-rayed and have mild arthritis in both. The non op leg, knee never bothers me. I'll just have to see how it progresses. My symptoms are different than yours also. No heaviness, just some stiffness with the op leg knee at almost one year post op.
Best of luck as you move forward. I hope you get some answers.
 

MammaT

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I get the knee pain with left hip (replaced almost 2 years ago). X-rays show nothing major. I think mine is from muscles, etc. working their way to normal, especially after right hip replacement. Massage and stretching of it band helps me.
 

GrannyC

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I forgot to add that I have that same stiffness @Layla mentioned. I thought it was gone after my THR but now it is back in both knees. I mostly notice it when I get up after sitting for a while.
 
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FraidyCat

FraidyCat

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Thanks, @Eman85, @GrannyC, @Layla, and @MammaT. After I see the rheumatologist on Monday I'll decide whether to make an appointment with the ortho surgeon who did my THR. The ortho surgeon's nurse responded to my email in which I asked whether the knee pain might be referred pain from the site of the new hip; she said it was highly unlikely. Hope she's right. Am also hoping that perhaps just some PT might decrease my symptoms, which aren't limited to heaviness or stiffness but include pain on weight-bearing, especially on stairs. Very similar to what I experienced prior to THR, except then the source of the pain was the hip whereas now it is -- or at least seems to be -- the knee. I'll post again after I see the rheumatologist.
 

Mojo333

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Best of luck for your appointment and hope you get some answers!
 
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FraidyCat

FraidyCat

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I saw the rheumatologist today. She's pretty certain that the knee pain is due to arthritis, though she ordered a blood test for gout (result was negative) as well as Lyme disease (still waiting for that result). She recommends PT up to twice a week, icing, and perhaps a knee support. I asked if the "inevitable," if this is OA like I had in my hip that was replaced in 2016, would be that I'd need a knee replacement and she said "not for a long time." Of course she has no way of knowing how long it might take for the symptoms to become debilitating. I know I have OA in my other (non-replaced) hip as well as my other knee. The prospect of needing four artificial joints over the next several-to-five-to-ten years seems daunting.
 

tim77

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I am almost 6 weeks post thr and it’s been a struggle. Difficulty sleeping due to the pain, knee pain, a lot of the symptoms you all have. I was told, “Wait until 6 weeks, that’s when you’ll start feeling better.” I am happy to report I think they’re right, I am finally starting to feel a lot better and am able to sleep through the night! That’s huge.

LTHR 6/20/2018
 

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