hi, thank you for providing the brief history of you. As you mentioned that post 1 year of TKR the pain is still persisting regardless of undergoing all protocols. It is sad to hear this. Well, let me help you further, the first thing you should is to visit the one who performed TKR and get the thorough orthopedic assessment. As the one who operated the knee has seen inside of your body well so he is the one to comment. Now to look further, total knee replacement, is it a bicompartment or tricompartment or unicompartment? this makes a lot of sense in understanding the Surgical procedure. To look ahead, post TKR how many weeks the physcial therapy was performed, I personally recommend my patients atleast 12 weeks of protocol and post that as per the assessment the next number of weeks will be designed. Also, to understand that prior to TKR you had a lot of weakness in the muscles of the thigh, hip and core. Now if this three area are not Strengthened to Muscle Grade 5, then you need some more input of the physcial therapy. Usually, my cases post TKR can perform 40 squats in a 60 seconds. also, they can perform, sprinting, running, jogging, jumping etc. I get 100% knee stability. Also, in TKR your internal structures of the knee are removed to provide a new implant. As the role of the implant is to just hide the knee joint sensory system to sensation less. The degenerative changes of the bone is irreversible. Also, as the internal structures of knee are removed, the joint is super immobile and only the strength in the muscles can hold the joint intact and get you rid of pain. There is alot to understand about the TKR, as what I mentioned is just a few points. With my patients I initially spend alot of time making them understand the Arthitis of knee, how to avoid TKR, What is the TKR procedure, what are the plus and minus of TKR, how to get the best joint stability and how the whole process will be followed with strenous exercises. By this, my 50% of Job is done as they understand their joint better and perfrom the best possible exercises advised under supervision. Within 12 weeks of time we get 80% stability and the last 20% we go slow but painful procedures and again in another 8 weeks all is settled. I wish you get your doubts clear by sitting down with a Surgeon and the physcial therapist as well to get the best results. Regards Jay Indravadan Patel