@knighthawk11 How frustrating to still have pain. I wonder from the description if you have a few physical things going on.
First, as frustrating as it us to us patients, when the surgeon takes an x-ray and says everything is okay, they mean the surgery was successful, the implant is where it is supposed to be, and their part of the job is done. But, there can still be healing going on, and perhaps nerve damage that must heal, scar tissue, gait problems or other issues.
Some of these can be improved with a close evaluation by the physiotherapist and specially designed exercises. Others may require further medical evaluation and maybe intervention.

So, perhaps you need to start with a physio visit and explain/demonstrate exactly what is going on. Then they can either recommend further specific therapy or referral for imaging (MRI or CT will show things and x-ray misses) and an appropriate doc.
Sue

Sue is totally correct...my surgeon said the same thing. X-rays and everything is working as it should. Extension and ROM are good yet all the muscles are still healing and I am just a little over a year. Scar tissue, inflammation and other things can cause issues. I still get extreme soreness and sometimes pain in my thigh muscle. The pain/soreness on the outside of my knee took almost 9 months before it got better. When it starts to get feeling worse I will wear a knee sleeve for a few days and the compression helps things quite a bit. I also went from a women's 11b Brooks shoe to a men's 9 1/2 wide because my feet were hurting so badly. After surgery you do walk differently because one knee is totally straight and perfect if done correctly so sometimes you need new shoes. This helped my legs and muscles as well. I can't wear the same shoes anymore. I went back to PT at 6 months and only go twice a month however I am being dismissed. Whenever I do the stretching exercises my leg will hurt for a few days after and to be honest I'm getting tired of it hurting but am told this is the only way to get the muscles stronger. I do everything I did before surgery and get up off the floor with a 12x15 foam pad that I can put my knees on and it doesn't hurt doing that. Make sure to check with PT before getting on your knee or your surgeon because I was told to wait 9-12 months from PT before even trying to get on my knee. I prefer to do my exercises on the floor because it's easier but I need the help of the foam pad to get up. Can't put my knee on a really hard surface. A good PT is important to your healing so if you aren't happy find another.

I am 4 and a half months out from TKR. The surgeon says everything looks good and my physical therapist says my range of motion is good. The problem is I still have pain and some swelling. I started pool walking back on August 18 and it does help with the walking. Right now I am on prednisone, the surgeon said that should make me feel better. I have muscle pain and burning around the kneecap and neuropathy. I still get up a couple times a night to ice my knee. The surgeon says it takes a good year to actually feel better, can’t wait to feel normal again. My other knee needs to be done. I am not going to do it unless there is no alternative. I can’t wait to feel normal again.

Hi, @knighthawk11. I combined your discussion with an existing discussion titled "Pain and Stiffness 6 months out from TKR" - https://connect.mayoclinic.org/discussion/pain-and-stiffness-6-months-out-from-tkr. You can read other experiences similar to yours from members @mrnomad, @cindymattern, and @afladland who are in varying stages of their recovery.