Wednesday, March 22, 2023

Groin Pain After Hip Replacement

What Causes Knee Pain After Hip Replacement Surgery

Femoroacetabular Impingement (FAI) | Hip & Groin Pain (Rehab | Education | Exercises)

Its not all that uncommon to have some knee pain after a hip replacement. Changes in the length of your leg can put some additional pressure or stress on your knee joint. Another common cause is that the sensory nerves that lie over your hip also provide sensation to your knee. This can cause perceived knee pain when its really coming from your hip.

Additionally, a total hip replacement may cause pain at first until your bone and the implant unite, which can be felt around your knees.

But you may want to get medical attention if your knee pain continues longer than a few months after surgery.

Read on to learn what can cause knee pain after a hip replacement, how long this type of pain typically lasts, and what you can do to help ease knee pain.

Painful Total Hip Arthroplasties

A painful total hip arthroplasty is a surgery where the hip joint is replaced with an artificial one. This surgery is usually very successful in relieving pain and restoring function, but it can be quite painful during the recovery process. The pain is usually worst in the first few weeks after surgery, but it should gradually improve as the incisions heal and the muscles and tendons adjust to the new joint. There are a variety of pain medications and other treatments that can be used to help manage the pain, and most patients are able to return to their normal activities within a few months.

This is a surgical procedure that causes extensive pain. A Learmonth ID, Young C, Rorabeck C. Total hip replacement has never been more common than it is today. Lavigne, et al., in Contributions to Human Development in the U.S. The result of total hip resurfacing is impingement of the hip joint. M. Wixson RL, Stulberg SD, and Mehlhoff M total hip replacement are all minimally invasive, cemented, or uncemented versions of the hip replacement. J Bone Joint Surg Am. is a textbook that focuses on treating osteoporosis.

In 2009, 91: 20738 was published. J Bone Joint Surg Br 1992 74-B :636) is the first publication to cite the article. In addition, the review looked at the value of aspiration of the hip joint prior to surgery to minimize the risk of infection.

Common Things That Cause Hip Pain And Can Confound A Diagnosis:

  • Low back pain from arthritis or sciatica, especially if the pain radiates down past the knee. This can be seen up to 30% of the time and should be evaluated as a possibility by the hip surgeon before surgery.
  • Bursitis and inflammation or tendonitis. Point tenderness or pain with laying on the side of the painful hip could be a sign of trochanteric bursitis. It is very common in patients and usually resolves with a cortisone injection.
  • Tendonitis around the hip muscles or subtle tears. Sometimes, inflammation around these tendons irritates the local nerves around the hip and can cause radiation or pain in the groin, thigh, and buttock. These can also usually be addressed with physical therapy, cortisone injections and anti-inflammatories. Most of the time, these soft tissue conditions resolve completely over time.

Advanced imaging can help rule out things like stress fractures, labral tears, cartilage tears, and tendon tears or other conditions causing hip pain like a pinched nerve in the back. Usually after a physical exam and basic x-rays of the hip to rule out hip bone abnormalities or obvious arthritis most physicians can identify the cause of hip pain, but it still can be elusive and will need close follow up.

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Hip And Groin Pain After Total Knee Replacement Surgery

by Anthony Maritato PT | Nov 8, 2021 | Total Knee Replacement

I couldnt find peer-reviewed data to support an answer to this question, but as a physical therapist with 20 years of history in the clinic, I can tell you that anterior hip and groin pain after a total knee replacement is not uncommon.

As of writing this article on November 8, 2021 I have two patients in the clinic with anterior hip and groin pain following a total knee replacement.

What Is Considered A Normal Amount Of Pain After A Hip Replacement Surgery

Surgical release of iliopsoas tendon for groin pain after total hip ...

Some swelling and initial pain at the joint are normal after hip replacement. To help reduce pain:

  • Take time to rest between therapy sessions.
  • Ice the leg and the incision site.
  • Take anti-inflammatory medications, after consulting with your doctor, to help with these symptoms.

Keeping the leg elevated above the heart when you lay down can also help the swelling to recede, advises Thakkar.

Its important to pay attention to your pain levels. If you feel like you are consistently at a 6 or more on a 110 pain scale, mention it to your doctor, because it could be a sign of infection or another complication. As you continue physical therapy, your pain levels should slowly decrease to about 1 or 2 in 12 weeks after the hip replacement.

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Why Does My Hip Hurt

If the cartilage in the hip joint degenerates and the hip joint develops arthritis, then many normal activities such as walking, standing, or sitting may result in hip or groin pain. Groin pain is a symptom commonly associated with hip arthritis.

Our team of orthopedic hip specialists begin by diagnosing the cause of your hip pain, and reviewing treatment options with you to get you back to your normal activities.

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Signs It May Be Time For A Hip Replacement

When is it time to consider a hip replacement? The orthopedic hip specialists at University of Maryland Medical Center may recommend hip replacement to patients who, after non-surgical treatments for hip arthritis, continue to suffer and have the following symptoms.

You can make an appointment with one of our hip specialists by calling or request an appointment online.

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How Groin Pain Is Diagnosed

Because groin pain can have many possible causes, your healthcare provider could diagnose your condition in a number of different ways.

Your healthcare provider will ask about your medical history and other details about your groin pain, such as:

  • When it started
  • Whether you experienced an injury
  • What makes the pain worse and better
  • Whether you have any other symptoms

You will usually need a physical exam. You may also need imaging tests to confirm the diagnosis.

Signs You Might Need Hip Replacement Surgery

Expert advice for Groin/ Front of hip pain

If youre reading this article, its likely that youre experiencing pain and stiffness in your hip. If the discomfort is more than a mild annoyance, there could be something wrong with your hip joint that may require hip replacement surgery. The good news is that: Orthopaedic & Spine Center of the Rockies is here to help.

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Create A Treatment Plan

After I identify the structure possibly contributing to the symptoms, I would develop a treatment plan to strengthen the tissue, facilitate normal tissue healing, ensure proper range of motion and mobility within the structure and minimize the negative effect in the surrounding tissues.

It can also help to try different assistive devices. If you want to know more about switching from a cane to a walker .

Hip Pain See A Physical Therapist

If you are experiencing hip pain that is not relieved by walking, you may be able to get a physical therapist to help you. Physical therapists can assist you in regaining your range of motion and strengthening your hip muscles. You can also consult with them about ways to reduce pain and improve your performance.

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Additional Challenges For Men

Recent studies show that women often have better outcomes than men following hip replacement surgery. Researchers looked at 97,000 cases of hip and knee replacements at an Ontario hospital and found that men:

  • Were more likely to make a trip to the emergency room within 30 days
  • Suffered from more heart attacks
  • Needed revision surgery more often
  • Were more likely to suffer a serious infection after surgery

If youre at a higher risk for complications, make sure to talk to your doctor about all of your concerns.

How Long After Hip Replacement Does Groin Pain Last

Persistent Groin Pain After Total Hip Arthroplasty

Most people report significant improvement in their groin pain within a few weeks after surgery. However, some people may experience ongoing pain or discomfort in the area where the incision was made. If you have persistent pain, your surgeon may recommend additional treatments.

While the use of uncemented femoral components after total hip replacement has been linked to more severe thigh pain, this has not been proven in all cases. In this article, we look at the prevalence, aetiology, clinical and radiological evaluation, and treatment options for patients who have persistent groin pain after all types of THR. After metal-on-metal hip resurfacing, a high percentage of groin pain is experienced. In the case of a patient, it is possible that they have several causes, all of which must be identified and treated in order for the patient to recover. Infection, aseptic loosening of the acetabular component, and polyethylene debris are among the most common intrinsic causes of bacterial infections. During metal-on-metal resurfacing, acetabular loosening can lead to groin pain. Female gender, femoral head cysts, and small component sizes were all found to be correlated with increased femoral loosening risk.

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Where Will I Feel Pain After Hip Replacement Surgery

You can expect to experience some discomfort in the hip region itself, as well as groin pain and thigh pain. This is normal as your body adjusts to changes made to joints in that area.

There can also be pain in the thigh and knee that is typically associated with a change in the length of your leg. This is one of the many reasons why its important to closely follow a physical therapy routine following your surgery. You will be asked to do various exercises during the day. Some patients continue to work with a physical therapist at home to learn how to correctly sit, stand, get out of bed, and walk. This process can be invaluable to get your mobility and strength back.

While it is common to experience some pain at the site of your incisions, new advances in technology have made this aspect of the procedure much easier. Smaller instruments allow for incisions of just three inches, rather than the larger incisions that were necessary in the past. This improved technique allows for less damage to the muscle and soft tissue. This can reduce the level of pain you can expect to experience after surgery.

What Treatment Options Exist

The best way to avoid groin pain after hip replacement is to avoid hip surgery altogether. Hip replacement surgery has been associated with significant complications which include pseudotumors , hip dislocations, strokes, metal toxicity due to wear particles, and an increased incidence in falls . In a recent study that followed 51 patients after hip replacement, activity level, and sleep were not improved at 6 months .

Treatment for groin pain after hip replacement depends upon the underlying source. Infection, a loose implant, and pelvic fracture require prompt surgical evaluation and may require additional surgeries. Conservative care in the form of rest, safe NSAIDs, stretching and PT are the initial treatment of choices for Iliopsoas tendonitis. When unsuccessful, steroid injections are often recommended. Steroids are powerful anti-inflammatory agents that are toxic to orthopedic tissue, and should be avoided. In addition, steroids also reduce local stem cell numbers and compromise immune system activity. Surgery is also an option if pain persists. In some cases, the Iliopsoas tendon is cut thereby relieving the pressure on the tendon. Unfortunately, this also significantly changes the biomechanics of the hip and lower extremity as the Iliopsoas tendon is a major stabilizer.

Are there new, natural treatment options? YES!

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What To Expect With Pain After Hip Replacement Surgery

Living with hip pain can be frustrating and debilitating, especially when it has an effect on how you go about your daily routine. You may find it difficult to simply walk upstairs or get adequate sleep. Dealing with this type of discomfort can even put a strain on relationships with the people who care for you every day. Whether the cause of your pain is due to an injury or a medical condition, your doctor may recommend hip replacement surgery if all other options have been unsuccessful. Unfortunately, pain after hip replacement surgery can occur as well.

As with any surgery, its normal to have concerns before you undergo any procedure. Its important to know, though, that the benefits often outweigh the possibility of complications and pain after hip replacement surgery. This post covers the information you need to know regarding pain after hip replacement surgery. We also discuss ways to cope with it and things to be aware of during your recovery.

Recovery Restrictions After Hip Replacement Surgery

Why Does My Total Hip Still Hurt?

You can expect to spend about three days in the hospital following surgery, though you may need to stay longer if your doctor recommends it. Your doctor or a physical therapist will discuss precautions you should be aware of for the weeks after your surgery. During this time, you will usually need to use crutches or a cane to stabilize your movements to prevent further injury.

Your physical therapist will also help you learn how to use a shower bench and raised toilet seat to make daily functions easier during your recovery.

Patients with a desk job can usually return to work within a month, but physicians dont recommend driving for several months. If your job requires more extensive physical activity, you will have to plan on staying home a number of months.

In terms of an overall recovery, you can expect to feel mostly back to normal within three months, but a full recovery can take approximately one year. Your doctor will be able to anticipate specific restrictions you may face due to your current condition and medical history.

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Rare Causes Of Joint Pain

These conditions are rare, but your healthcare provider may consider them if you have groin pain that cannot otherwise be explained.

Infected Joint

Rarely, the hip joint may become infected. This is most common in people over age 80. It can also happen in people with certain medical conditions/circumstances, such as:

This condition causes severe groin pain, especially with leg movement. You may also have fever, swelling, warmth, and redness around the hip.


Very rarely, a tumor in a muscle or bone may cause groin pain. This is especially true if the tumor is in the area of the inner thigh muscles.

Unlike a groin strain, groin pain from a tumor does not generally worsen with exercise.

Prp And Stem Cell Treatments

PRP is rich in growth factors that can increase blood flow and decrease inflammation. Your stem cells are powerhouses of healing and can recruit other cells in your body to accelerate healing. The Iliopsoas tendon is easily seen and evaluated during an ultrasound examination. At the Centeno-Schultz Clinic were are experts in the treatment of hip and tendon injuries. All PRP and stem cell injections are performed under x-ray or ultrasound guidance to ensure that the cells are injected at the right place. This, in turn, results in better clinical outcomes and patient satisfaction.

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Osteonecrosis Of The Femoral Head

This issue, known as ONFH, causes the hip bone to deteriorate and collapse due to a lack of blood to the area. The cartilage that covers the hip bones also deteriorates, resulting in arthritis.

Hip pain is typically the first symptom, and it may accompany a throbbing pain or dull ache in the buttocks and groin. As the condition progresses, it may be difficult to put weight on the hip and any movement may be painful.

This may progression can take several months to a year, and getting an early diagnosis leads to a better outlook.


Internal causes of hip and groin pain may stem from underlying conditions or growths in other regions of the body. The issue may be:

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Left Hip Pain And Groin 3 Years After Posterior Total Hip Replacement

Andy Murray serves up ace way to end agony of NHS hip

2016 I had total hip replacement via posterior approach. 2017 I had total hip replacement anterior approach. The posterior approach side constantly hurts, but I get intense pain under load , and the intense pain also makes it impossible to sleep at night. Is anyone else having my symptoms after total hip replacement? I now use a cane for stability, and an electric scooter for long distance travel after my fifth fall. I feel alone with issue, but I cant imagine others dont experience my symptoms? Am I all alone? Im at my wits end, depressed, and now suffer with anxiety as a result of last hip pain. Help.

I had posterior TJR in 2018. I have the same symptoms as you. I just completed a battery of tests to determine the cause of my pain. I no longer really exert myself to avoid the intense pain. But just doing regular housekeeping activities triggers the pain for me. I am still steady on my feet but long walks, periods of standing or sitting trigger the pain. The doctors could find nothing wrong with me. They have sent me to PT for core, hip and glut strengthening. I just am in my second week of that. It is very frustrating. Especially getting people to believe me.

Hoping someone else has some answers for us!!

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