Me oni moving a male patients leg around to assess for pain following a hip replacement.

conditions

Pain Following Hip Replacement

Most hip replacements are a great success, but for some people pain lingers, or returns months or years later, in the groin, thigh, buttock or even the knee. There is almost always a reason, and most causes are treatable. As regional lead for the revision hip service in East Kent, Mr Oni is well placed to find out why.

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What causes pain after a hip replacement?

Pain after a hip replacement: finding the cause, from soft tissue to the implant

The vast majority of hip replacements are a lasting success, leaving most people far more comfortable and active for many years. In a smaller number, pain continues after recovery, or returns after a comfortable period, and is felt in the groin, thigh, buttock or sometimes the knee.

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Pain like this almost always has a specific cause, and importantly, most of those causes are treatable, often without further surgery. The key is a careful assessment to find exactly where the pain is coming from.

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As regional lead for the revision hip service, leading the MDT at East Kent Hospitals, Mr Oni assesses painful hip replacements regularly and is experienced in telling the different causes apart.

knee with sports tape across the kneecap

Recognising the problem

Signs of a problem after hip replacement

Some aches and twinges are a normal part of recovery, especially in the first few months. The signs worth getting checked are pain that is new, getting worse, or lasting well beyond your expected recovery, particularly in the groin, thigh or buttock, or pain that comes back after a pain-free period. These are the patterns Mr Oni looks out for.

Groin pain

Pain felt deep in the groin, sometimes on standing or walking, which can point to the front of the new joint or a tendon.

Thigh pain

Aching in the thigh, particularly on weight-bearing or after activity, which can relate to the stem of the implant.

Buttock pain

Pain in the buttock, which can be referred from the lower back or come from the back of the hip.

Outer hip pain and tenderness

Pain and tenderness on the outside of the hip, often from the tendons or bursa rather than the joint itself.

Pain on weight-bearing

Discomfort that comes on when you put weight through the leg, and eases with rest.

Pain that returns after being well

Pain that comes back after a comfortable, pain-free period, which is always worth assessing.

Knee or leg pain

Pain referred down to the knee or leg, or a sense that the leg lengths feel different.

Swelling, warmth or feeling unwell

Swelling, warmth, redness or feeling generally unwell, which should be checked promptly to rule out infection.

Pain felt around a hip replacement does not always come from the hip itself. It can be referred from the lower back or the other hip, or come from the soft tissues rather than the implant. This is exactly why a careful assessment matters, and Mr Oni will work out where your pain is really coming from before recommending anything.

The causes of pain after a hip replacement fall into a few groups. Some come from the soft tissues around the new joint, an irritated tendon at the front of the hip, or the tendons and bursa on the outer side, which can be painful even when the implant itself is perfect. Others are referred, with pain travelling from the lower back or the opposite hip into the area of the replacement.

A separate group of causes relates to the implant itself. Over time a replacement can loosen or wear, or in some cases become infected, and occasionally the bone around it can fracture. These are less common, but they are important to identify because they are the ones most likely to need revision surgery.

Finally, mechanical factors such as a difference in leg length or the position of the components can cause ongoing discomfort. Because the right treatment is completely different for each of these, pinning down the cause always comes first.

Soft-tissue causes

Irritated tendons or bursa around the new hip, such as the tendon at the front or the tendons on the outer side. Often treatable without further surgery.

Implant-related causes

Loosening, wear, infection or a fracture around the implant. Less common, but the causes most likely to need revision surgery.

Referred or mechanical causes

Pain referred from the lower back or other hip, or discomfort from a leg-length difference or the position of the components.

causes and types

What causes pain after a hip replacement?

a close up image of two computer screens on Mr Oni's desk with a hip x-ray and scan visible on the display,

how mr oni Helps

diagnosis & Next Steps

Getting the diagnosis right comes first, and with a painful hip replacement that means methodically working through the possible causes. Mr Oni will ask how and where it hurts and examine the hip, then arrange the right tests, usually X-rays, and where needed blood tests to check for infection or a scan to look at the soft tissues and the implant. As regional lead for the revision hip service in East Kent, he is used to getting to the bottom of difficult cases, so your treatment is based on a clear answer.

01

consultation

A thorough consultation reviewing your symptoms, movement, and any existing imaging. No assumptions, no rushed conclusions.

02

clinical examination

A hands-on assessment of the joint - checking movement, strength and what triggers your pain - to understand exactly what's going on.

03

imaging

Where needed, an X-ray or scan to confirm the diagnosis and see the joint clearly, so nothing is left to guesswork.

04

treatment plan

Every option considered. From load management and physiotherapy to further investigations and surgical options. A plan built around your lifestyle and goals, not a one-size-fits-all protocol.

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with the right treatment

life after treatment

Comfortable on your feet again

With the cause treated, walking and standing become comfortable, and the replacement does what it was meant to.

Answers, not uncertainty

Knowing exactly what was causing the pain, and having a clear plan, is a relief in itself.

Often without more surgery

Many causes are settled with an injection, physiotherapy or treating the real source, rather than another operation.

Back to enjoying the result

Returning to the activities the replacement was meant to give back, with confidence in the hip again.

Recognising the problem

How pain after a hip replacement is treated

Treatment depends entirely on the cause, which is why diagnosis comes first. Soft-tissue and referred causes are often settled without further surgery, with physiotherapy, activity changes, or a targeted injection. Where the problem lies with the implant, such as loosening, wear or infection, revision surgery to adjust or replace part of the hip may be the answer. As regional lead for the revision hip service in East Kent, Mr Oni offers the full range, and will only recommend further surgery when it is genuinely the right step.

related treatments

Hip Revision Surgery

Replacing or repairing a hip implant that has worn, loosened or failed, including complex cases referred by other surgeons.

Hip Revision Surgery
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an elderly person climbing the stairs clutching their lower back in pain
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Patient Stories

Hear from patients who have undergone investigations and treatments for their hip and knee problems with Mr Oni.

★ ★ ★ ★ ★

Mr Richard M.

Mr Oni explained everything clearly and the whole process was faultless. I was walking the corridors within two days and driving again in a fortnight. The scar is so neat you can hardly see it.

Treatment

Hip Replacement

★ ★ ★ ★ ★

Mr Robert F.

Mr Oni and the team were very professional throughout. The recovery was tough, but I stuck to the exercises and only needed over-the-counter painkillers. Two months on, I completed a nine-mile bike ride.

Treatment

Robotic Knee Replacement

★ ★ ★ ★ ★

Ms Liz.

Mr Oni and Libby are a really good team and made me feel completely comfortable. I'd been limping for a year, but almost marched into my follow-up. I've got my life back.

Treatment

Arthrosamid Injection

★ ★ ★ ★ ★

Mr Tony G.

Mr Oni gave me real confidence going into surgery, and I cannot fault my experience. I'm back to walking the dogs, gardening and farm work. The steep hills that once bothered me, now I don't even notice.

Treatment

Robotic Knee Replacement

★ ★ ★ ★ ★

Ms Zoe G.

Mr Oni and the team were incredibly supportive, kind and patient. I was walking with a frame the same day and dressing myself the next morning. Within two weeks I could pick my daughter up from school.

Treatment

Hip Replacement

★ ★ ★ ★ ★

Mr Ian F.

Mr Oni recommended the Arthrosamid injection and everything has been brilliant. Two weeks later I was rotovating the garden for two hours. It felt like some sort of miracle, I didn't notice I'd had bad knees.

Treatment

Arthrosamid Injection

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Take the next step

Get to the bottom of your hip replacement pain

If your hip replacement is painful, whether the pain is new, lingering, or has come back, Mr Oni will find out why and explain your options clearly. Many causes are treatable without another operation, and where revision is needed you are in expert hands. No pressure, no assumptions.

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locations

Mr Oni consults and operates at several leading private hospitals across the region, so you can choose the location most convenient for you.

Exterior Image of The Horder Centre Crowborough East Sussex

The Horder Centre

St John's Road
Crowborough
East Sussex
TN6 1XP

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Exterior Image of the Nuffield Health Private Hospital in Tunbridge Wells

Nuffield Health

Kingswood Road
Tunbridge Wells
Kent
TN2 4UL

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Exterior Image of the Vale Health Clinic in Tunbridge Wells, Kent

Vale Health Clinic

31-33 Vale Road
Tunbridge Wells
Kent
TN1 1BS

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Frequently asked questions

Some aching and discomfort is completely normal in the first weeks and months as you recover, and it should ease steadily over time. Pain that is new, getting worse, or still significant well beyond your expected recovery is the kind worth having checked.

Buttock pain after a hip replacement is often referred from the lower back, or comes from the muscles and tendons at the back of the hip, rather than the implant itself. Less commonly it points to a problem with the replacement, so it is worth assessing to find the real source.

Groin pain is commonly due to irritation of the tendon at the front of the hip rubbing on the implant, or to the soft tissues, and is often treatable without further surgery. Occasionally it can signal loosening, so a proper assessment is sensible if it persists.

New pain that appears years after a successful replacement should always be checked. It can come from gradual wear or loosening of the implant, or from a soft-tissue problem, and identifying the cause early gives you the most treatment options.

Often not. Many causes of pain after a hip replacement are settled with physiotherapy, an injection, or treating the real source of the pain. Revision surgery is reserved for specific problems with the implant itself, such as loosening, wear or infection.

It is best seen by a surgeon experienced in revision hip surgery, who can tell the many possible causes apart. Mr Oni is regional lead for revision hip surgery in East Kent and regularly assesses painful hip replacements.

get in touch

Book your initial
consultation

See Mr Oni at The Horder Centre, The Nuffield Hospital or The Vale Health Clinic.

Fill in the form below or get in touch directly:

Email: libby.gibbs@horder.co.uk

Call: 01892 362736

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Mr Oni walking with his practice manager in a hospital corridor
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