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Top 5 concerns after knee or hip replacement surgery (and when they’re actually a problem)

Complications After Surgery

You’ve just had a knee or hip replacement and aren’t sure if the symptoms you are experiencing are normal. These are the top five things my patients worry about in the first two weeks after their surgery. I go through each one and explain what is normal and what isn’t – when you should contact your surgeon or physiotherapist.

1. Swelling
A warm and very swollen knee or hip is normal and many patients experience this. If the swelling in your leg subsides over night when you sleep or when you elevate your leg, you don’t need to be concerned. One of the best ways to reduce swelling is by icing the area.
When swelling is a sign of a clot:
An extremely swollen leg could be a sign that you have developed a clot, called deep vein thrombosis (DVT), which can be fatal. If you wake up in the morning or elevate your leg and the swelling doesn’t start going down, you must contact your surgeon to check you for DVT. Your surgeon will send you for an ultrasound to check for a clot and may ask you to take stronger blood thinners.
When swelling is a sign of infection:
If your joint becomes warm or swollen when it wasn’t before and your wound starts oozing, you need to contact your surgeon immediately to check the wound for infection.

2. A leaking wound
After surgery, you will be discharged from hospital with a waterproof dressing over your wound. Your dressing should remain clear. If it becomes blood stained, has any liquids seeping onto it, or falls off you need to contact your surgeon immediately as there is a high chance that your wound has become infected.
Infections are rare with only 0.5 – 2% patients experiencing an infection after a total knee or hip replacement.1 The quicker and more efficiently an infection is treated, the less chance that your new implant will be affected. If you come back with a leaking wound, we will take you into theatre to wash out the wound and take a tissue biopsy. Based on the biopsy results, we will start the appropriate treatment for the infection. Most people who have an infection treated immediately, will still experience a good outcome for their knee or hip replacement.
The longer you wait to address a leaking wound, the more likely you are to need multiple surgeries to address the problem and the worse the outcome.

3. Bruising
Bruising is completely normal even though it may seem quite alarming to you. Some patients don’t bruise much, and other patients experience extreme bruising along their entire limb. You will be taking a blood thinner, which can increase bruising. You may also bruise more in summer during hot weather.
The best way to reduce bruising is to ice the area.

4. Stiffness
You might experience some stiffness in your joint. This could be due to swelling which restricts movement in your leg. Once your swelling has subsided, the stiffness should too and movement in your leg will improve.
Stiffness is a concern if you are progressively losing more and more range of motion in your leg. If you are experiencing this, please contact your physiotherapist to examine you and help with your range of motion.

5. Pain
The most pain you will feel will be in the first 24 to 48 hours after surgery. However, your pain should be well-managed with the pain medicine we prescribe. We will manage your pain using different kinds of medicine and we will guide you on how to take them appropriately. If you do not take your pain medicine, you are likely to experience severe pain.
We also use a scoring system from 0 – 10 to monitor your pain or discomfort. Some discomfort is normal. However, if you are in pain and you don’t want to move, this could impair your recovery.
If your pain does not settle or gets worse despite using pain medicine as directed, please contact us.
Call your provider if you are worried
Stiffness, bruising and swelling can all be treated by a physiotherapist. Your physiotherapist can give you peace of mind about your symptoms and possibly provide therapy to reduce some of the symptoms. If you experience any of the most worrying symptoms such as an oozing wound, please don’t hesitate to contact your surgeon for advice and a consultation.


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