My knee replacement still hurts after a year. Do I need a revision?

How common is ongoing pain?

Most people improve steadily in the first year, and some take longer to settle fully. A minority are left with pain that limits them, and this deserves proper investigation rather than reassurance alone.

The pattern of pain gives clues. Pain at rest and at night can suggest infection or loosening. Pain on stairs may point to the kneecap or instability. Burning or electric pain may come from nerves.

Possible causes to check

• Low-grade infection, which may not cause fever or redness
• Loosening of an implant component
• Instability or a poorly balanced knee
• Kneecap tracking or wear problems
• Stiffness from scar tissue
• Pain referred from the hip or lower back
• Nerve irritation around the scar, or a regional pain syndrome

How it is investigated

Usually this involves a detailed history and examination, a series of X-rays compared over time, blood tests for inflammation and often a sample of joint fluid tested for infection. CT scans, bone scans or nerve assessments are added in selected cases. Examining the hip and spine is part of the process.

When revision is, and is not, the answer

If testing shows infection, loosening, instability or a clear mechanical problem, revision often improves symptoms. If no cause is found, a further operation is less likely to help, and pain management, physiotherapy and sometimes nerve-targeted treatment may be better options. At Aman Hospital, Dr. Gelber explains which situation applies to you before any decision.