Pain After Knee Replacement: Normal or Not? | Prof. Dr. Ibrahim Shaarawi

Quick answer

Pain after knee replacement is normal for the first weeks and eases steadily, with most improvement by 3 months. Swelling can persist for months. Pain that is severe, increasing, or returns after a period of improvement needs assessment for infection, stiffness, loosening or pain referred from the hip or spine.

✅ Last medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, on 12 October 2026

About your surgeon: Prof. Dr. Ibrahim Shaarawi

Professor of Orthopaedic Surgery, Faculty of Medicine, Ain Shams University.
Visiting Professor of Orthopaedic Surgery, Ohio, USA.
Certificate in complex fractures and trauma, University of Maryland, USA.
He has performed more than 750 knee replacements (total, partial, both knees in one operation and revision surgery) and more than 3,000 knee arthroscopies.
His joint replacement experience also includes 650 total hips, 1,400 hip hemiarthroplasties and 55 reverse shoulder replacements.
Rated 4.9 and 5.0 on Google by about 300 patients.

He sees patients at his clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement).

Patients often worry when the knee still hurts weeks after surgery. Most of the time this is part of normal healing, but some patterns need checking. Here is how to tell the difference, part of our guide to total knee replacement surgery.

Normal pain and swelling: what to expect

Time after surgery	What is usual
Weeks 1–2	Moderate pain, especially with exercise; marked swelling
Weeks 3–6	Pain easing; swelling worse in the evening
Months 2–3	Mild aching after activity
Months 3–12	Occasional stiffness; slight warmth and swelling fading

Table: the usual course of pain after knee replacement

Side-view X-ray of a total knee replacement after surgery — X-rays help rule out loosening or malposition when pain persists — Image: Mikael Häggström, M.D. / Wikimedia Commons, CC0

Continuous passive motion machine bending the knee after replacement — Knee bending starts early after surgery — Image: Assayas / Wikimedia Commons, CC BY-SA 4.0

Causes of persistent pain

Stiffness from limited bending in the early weeks.
Infection — warmth, redness, discharge or fever.
Implant loosening or malposition.
Pain from elsewhere — the hip or lower back can cause knee pain.
Nerve sensitivity around the scar.
Instability causing aching and giving way.

Video: Walking on the same day as knee replacement

Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, explains (in Arabic).

How we find the cause

Examination of movement, stability and the wound.
X-rays compared with earlier films.
Blood tests for inflammation, and joint aspiration if infection is suspected.
Examination of the hip and spine.

Key numbers to know

In the best-quality studies, about 20% of patients reported troublesome long-term pain after knee replacement (10%–34% across studies) (Beswick et al., BMJ Open 2012).
Across 18 randomised trials (1,739 patients), physiotherapy improved function and pain at 3–4 months after knee replacement, and home exercise worked as well as clinic sessions (Artz et al., 2015).

At Prof. Dr. Ibrahim Shaarawi’s clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement) we examine the knee and review standing X-rays at the same visit, then decide on conservative care, osteotomy, or a partial or total knee replacement according to the arthritis grade, your age and activity.

Treatment of pain after knee replacement

Most early pain responds to combined pain relief, ice, elevation and continued exercise. Stiffness needs more intensive physiotherapy; infection, loosening or instability may need surgery — see failed knee replacement and revision surgery. Do not stop the exercises because of pain; take your painkiller before the session instead — see exercises after knee replacement.

Swelling after knee replacement

Swelling is normal and can last for months, worse after activity and in the evening. Elevating the leg, ice and calf exercises help. Sudden calf swelling with pain may be a blood clot and needs urgent review — see knee replacement complications.

Looking for an experienced knee surgeon? Read our guides to the best knee specialist in Egypt and the best orthopaedic surgeon in Egypt to see how to choose.

Frequently asked questions about pain after knee replacement

How long does pain last after knee replacement?

It eases steadily over 6–12 weeks, with occasional aching for some months.

Is it normal for the knee to be warm months later?

Mild warmth can last several months; increasing warmth with redness, discharge or fever needs urgent review.

Why does my knee hurt more at night?

Swelling and stiffness build up after a day’s activity; elevation, ice and painkillers before bed help.

Can pain come from the back or hip?

Yes — hip arthritis or nerve compression in the spine can cause pain felt in the knee.

When should I worry about pain after surgery?

If it is severe and worsening, returns after improving, or comes with fever, redness or discharge.

To have your knee assessed and your X-rays reviewed, book a consultation, call +20 155 240 4488 or message us on WhatsApp at +20 155 554 7181.

Medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery. This article is general medical education and does not replace an examination or the treatment plan your surgeon sets for you. See our medical disclaimer.

Related knee replacement guides

Guides for recovery after surgery:

Pain and Swelling After Knee Replacement: What Is Normal and When to Worry