Numbness & Kneeling after Knee Replacement

This is a very common question I get from patients after total or partial knee replacement surgery. Patients are wondering why parts of their knee is numb after surgery. As you can see in this picture, there is a skin nerve in the front of the knee. During knee replacement the incision is in front of the knee and it is difficult/impossible to avoid this small branch of the skin nerve. Because of this many patients end up with a relatively small area of numbness in the front outside part of the knee below the kneecap after surgery. This is completely normal. It may at first feel like a bigger area, but it gets smaller over time. Nerves take a long time to heal after surgery. The good thing is that it doesn’t affect the function of the knee, it only affects the skin sensation in that one part of the knee.

A related question people ask is whether they can knee after knee replacement. The answer is that kneeling is completely safe after knee replacement after the skin incision has healed (say 4-6 weeks after surgery). However, some patients feel uncomfortable kneeling - probably in part because of this skin nerve and the skin numbness in the front outer aspect of the knee. This can usually be desensitized over time so that almost all knee replacement patients are able to kneel on their knee once they are fully recovered. Kneeling does not cause damage to the internal parts of the knee replacement in any way.

What is the Recovery After Hip Replacement?

This is a question I get asked essentially every day in the office. This has different meanings to different people, some people mean when can I go back to work or to driving or to full activity. In this post I will try to break down what the recovery process is like for most patients after anterior total hip replacement surgery.

Back in 2018 only 9% of my hip replacement patients went home on the day of surgery. That has changed a lot and now in 2025 about 65% of my hip replacement patients were done as outpatients without staying overnight in the hospital. That shows how much surgical and anesthetic techniques have improved over the last few years.

Whether a patient goes home on the same day or stays overnight one night in the hospital, all patients start walking with a walker for safety purposes. Patients are allowed to walk right away after hip replacement and can put weight on the leg that had surgery. Then, patients can progress to using a cane (in the hand opposite from the hip replacement) as they feel confident and strong enough. Most young, healthy, and active patients will stop using the walker within a few days after surgery. Some older and less active patients will need to use the walker for at least 2-3 weeks after surgery. I would estimate maybe 1/3 of patients return for their initial postop appointment 2 weeks after surgery without a cane, 1/3 are using a cane, and 1/3 are still using a walker.

Most patients after hip replacement can start to drive after 1-2 weeks if their left hip was replaced, and 2-3 weeks if their right hip was replaced. Patients can return to working from home after a few days, they can return to office desk work after 2-4 weeks, and then heavier duty, more manual labor or construction type work will require 6 weeks - 3 months to return to work.

Full recovery after total hip replacement surgery takes at least 12-18 months, but most of the recovery is the first 6-8 weeks. Patients can return to light golfing after about 6 weeks. Full activity such as running or pickleball I wouldn't recommend for about 6 months after hip replacement.

Severe Knee Pain Causes Guide: Understanding the Causes of Severe Knee Pain

Severe knee pain can disrupt daily life and limit mobility. Understanding the causes of severe knee pain helps in managing symptoms and seeking appropriate treatment. Knee pain often results from injury, wear and tear, or underlying medical conditions. This guide explains common causes, symptoms, and practical steps to address severe knee pain.

Severe Knee Pain Causes Guide: Common Reasons for Knee Pain

Knee pain arises from various sources. The knee is a complex joint made of bones, cartilage, ligaments, and tendons. Damage or stress to any of these parts can cause pain. Here are some common causes:

• Osteoarthritis: This is the most common cause of knee pain in adults. It results from the gradual breakdown of cartilage, leading to bone rubbing on bone. Osteoarthritis causes stiffness, swelling, and pain, especially after activity.

• Rheumatoid Arthritis: An autoimmune condition that causes inflammation in the knee joint. It leads to pain, swelling, and joint damage.

• Meniscus Tears: The meniscus is cartilage that cushions the knee. Tears can occur from sudden twisting or degeneration with age. This causes sharp pain, swelling, and difficulty moving the knee.

• Ligament Injuries: The anterior cruciate ligament (ACL) and other ligaments stabilize the knee. Injuries often happen during sports or accidents, causing severe pain and instability.

• Bursitis: Inflammation of the bursae, small fluid-filled sacs that reduce friction in the knee. Bursitis causes localized pain and swelling.

• Tendinitis: Overuse or strain of tendons around the knee leads to tendinitis. It causes pain during movement and tenderness.

• Patellofemoral Pain Syndrome: Pain around the kneecap due to misalignment or overuse. It is common in runners and active individuals.

  
  

Each cause has distinct symptoms and treatment options. Identifying the exact cause is essential for effective management.

Close-up view of a human knee joint showing bones and cartilage

Diagnosing Severe Knee Pain

Proper diagnosis involves a detailed medical history, physical examination, and imaging tests. I recommend the following steps:

1. Medical History: Discuss when the pain started, its intensity, and any injury or activity that triggered it.

2. Physical Exam: The doctor checks for swelling, tenderness, range of motion, and stability of the knee.

3. Imaging Tests:

4. X-rays show bone alignment and signs of arthritis.

5. MRI scans provide detailed images of soft tissues like ligaments and cartilage.

7. Ultrasound can detect inflammation or fluid buildup.

Accurate diagnosis helps tailor treatment plans. Early diagnosis can prevent worsening of the condition.

Is Walking Good for Knee Pain?

Walking is a low-impact exercise that can benefit many people with knee pain. It helps maintain joint mobility and strengthens muscles around the knee. However, the effect of walking depends on the cause and severity of the pain.

• For mild to moderate osteoarthritis, walking regularly can reduce stiffness and improve function.

• If the knee pain is due to an acute injury or severe inflammation, walking may worsen symptoms.

• Proper footwear and walking on even surfaces reduce stress on the knee.

• Start with short walks and gradually increase duration as tolerated.

• Avoid walking on hard or uneven terrain if it causes pain.

  
  

Consulting a healthcare provider before starting a walking routine is important. They can recommend exercises that support knee health without causing harm.

Eye-level view of a paved walking path in a park

Treatment Options for Severe Knee Pain

Treatment depends on the underlying cause and severity of the pain. Common approaches include:

• Medications: Over-the-counter pain relievers like acetaminophen or NSAIDs reduce pain and inflammation.

• Physical Therapy: Targeted exercises improve strength, flexibility, and joint stability.

• Injections: Corticosteroid injections reduce inflammation. Hyaluronic acid injections lubricate the joint.

• Assistive Devices: Braces or orthotics support the knee and improve alignment.

• Lifestyle Changes: Weight loss reduces pressure on the knee. Avoiding activities that worsen pain is important.

• Surgery: In severe cases, minimally invasive procedures or knee replacement surgery may be necessary.

  
  

Advanced techniques, including robotic-assisted surgery, offer precise treatment with faster recovery. These options are especially beneficial for patients seeking to return quickly to an active lifestyle.

Preventing Severe Knee Pain

Prevention focuses on protecting the knee joint and maintaining overall joint health. Here are practical tips:

• Maintain a healthy weight to reduce joint stress.

• Warm up before exercise and stretch afterward.

• Use proper techniques during physical activities.

• Strengthen muscles around the knee with regular exercise.

• Avoid repetitive high-impact activities that strain the knee.

• Wear supportive shoes that fit well.

• Address minor knee pain early to prevent progression.

  
  

Taking these steps can reduce the risk of developing severe knee pain and improve quality of life.

When to Seek Medical Help

Seek medical attention if you experience:

• Severe or persistent knee pain that limits daily activities.

• Swelling, redness, or warmth around the knee.

• Inability to bear weight on the leg.

• Knee instability or locking.

• Fever with knee pain, which may indicate infection.

  
  

Early intervention improves outcomes and prevents complications.

Understanding the causes of severe knee pain is the first step toward effective treatment. With proper care, it is possible to manage pain and maintain an active lifestyle.

This guide provides clear, practical information to help manage severe knee pain. Taking action early and following recommended treatments can lead to better joint health and improved mobility.