Swollen Ankle after Anterior Hip surgery

Swelling is normal after major surgery, and one week is very early days in recovery. UNLESS you develop a hot, painful or red area, which may be a sign of a blood clot, you can do some self-care and see if it resolves. If this develops call the doctor immediately or go to the ER.

From my own experience in hip replacements (5 of them) the tendency is to "feel pretty good" and slack off on icing & elevation. I know that most literature recommends icing "20 minutes, 3-4 times a day." Here is my personal experience - if you ice pretty much full time, whenever seated or lying down, for the first month, you will not see the swelling. Also, especially for the first month, whenever you sit for more than a few minutes (like to eat a meal) your leg should be elevated.

Remember, your body has been assaulted. Never mind the promotions saying "anterior is easier" - you have still had skin, muscle, nerves and bone either cut or moved around - they are NOT happy. The fluid and swelling is your body's response to the assault, a reminder that all is not healed.

To get the swelling down, elevate your leg above your heart & ice - it may take up to 48 hours to calm down. Then follow the icing/elevation guidelines above. While swollen, if someone can massage the elevated leg, "pushing" the swelling from foot toward your groin, it may help get things moving. Don't quit walking unless your doctor tells you to - just make sure you get that leg up whenever you are not using it.

If the swelling doesn't go away in a couple days of doing the elevation & icing, call your doc.

Are you noticing any improvement today?
Sue

PS After my first hip replacement, I went back to work at 4 weeks, tried to keep the leg up at my desk, and even used my ice a few times a day. But I went home swollen every night for the first month. After the second operation, I worked from home weeks 2-6, so I could stay elevated. It was a much better plan!

Thank you Sue for the very complete and thoughtful answer. I was surprised at having so little swelling and then after sitting without elevation for a couple hours, I have significant swelling in leg and ankle.

The swelling has not settled down as much as I would like. I will take your suggestions to heart and hopefully see decreased swelling over the next day or so. I will continue my walking and hospital exercise regiment.

I have been doing so amazing and I was shocked that after only a brief period of not elevating my leg, things fell apart. I won't let that happen again. 🙂

Thanks so much,
Craig

You are welcome. Just treat yourself like a fragile flower for a couple weeks. You will heal better and be far ahead of the curve later. Do you have anyone who can massage your leg to get the fluids moving?
Sue

My wife massaged my leg last night in bed. She pushed in the way you suggested. I slept with a pillow under my feet to elevate them some even in bed. I am now more aware that having sitting without elevating my legs is a no, no.

Swelling is still thee this morning but less. This is day 8, I am able to walk short distances without any assistant device. I am walking about 3 times a day outside . Yesterday, I was able to do my first walk without my cane (.6 miles).

I continue to do the strength stretching exercises from the hospital. There are a couple of stretches that are challenging my range of motion. My bad hip limited my range of motion significantly . Reclaiming it is a challenge.

Thanks again for your help and interest.

Craig

I am going through the same problem, just had total hip replacement, was assured I’D be up and walking and we’ll recovered but 6 weeks. Now I’m 9 days post op and have bruising down my leg, swelling in calf (not too bad) and swelling and some bruising around the ankle and top of foot...I try to elevate it, but been told to rest is to rust. I do the ankle pumps , the other exercises and ice pack as much as you can to a foot and ankle...all say normal healing process, ebb and flow of liquids etc..
PT comes again tomorrow...I guess after reading your article I should be somewhat assured which I am, but feel that the med team should tell a patient more of what to expect in the following weeks after surgery..
Any feedback welcome thanks

I would like a dollar for every joint replacement patient who wrote, "assured I’D be up and walking and we’ll recovered but 6 weeks..." - I would take a trip to Hawaii!
Please read this message, which I wrote last night after reading it for the 3rd time just yesterday:
https://connect.mayoclinic.org/discussion/had-hip-replacement-wondering-about-topical-numbing-agent/?pg=2#comment-837174
25 years ago, if you had your hip replaced, you would only have gotten home from the hospital a day or two ago. Your stitches are still in your leg, your bone has been sawed and pounded, and you lost a lot of blood (that's the swelling and bruising you see.) Bones, nerves and muscles need to heal, your blood volume needs to return to normal, and you need to rebuild your strength. Today, in our instant society, there is an illogical expectation that nature no longer rules, and somehow we can speed up that process.

As for "I try to elevate it, but been told to rest is to rust..." True, to a point. You do need rest to heal, and that alone takes at least 6 weeks. Also, as long as the swelling and bruising is there, when you are seated, elevate that poor leg and ice it as much as you can. I went back to (office) work at 4-6 weeks, after both knee and hip surgery, with my trusty ice packs, and kept my leg propped up unless I was up walking around. But, that also means to get up and move - 5 minutes or more every hour. Do your PT exercises every day - twice a day - for several months. And walk, walk, walk...

I hope this encourages you to understand that what you are experiencing is normal, and that if you allow your self time to heal, and do your therapy, you will have a happy result - it just might be more than 6 weeks.
Sue

Thanks Sue,

For a good in-depth and reassuring reply...

May I asked how do you use an ice pack on your top of foot and side and keep it from falling...I may also try to elevate that foot tonight with a small couch pillow..

Many Thanks

Hello. My dad had hip replacement surgery 1 week ago and now has some swelling in his ankle. I have read the comments but have a few additional questions. He has been elevated his leg in bed but finds it very uncomfortable to raise his leg ‘very high’ while sitting to eat or during the day - he has bad arthritis in back also. Is it better to stay laying down with foot elevated most of day or does just elevating to where leg is somewhat straight good (12” up)”? He also finds it better to sleep on side now - should his leg be elevated also or is it ok to have it just flat on bed? Thank you in advance - I will try and find more comments in case I missed one that is related.

Thank you for being an advocate for your Dad and welcome to Mayo Connect! Are you also his caregiver? I think it is important to to have a helper/cheerleader/prodder close at hand for the first few weeks as much as possible.

Swelling in ankles and calves after hip replacement is totally normal, it is a sign that surgery has caused a major disruption to the body. Elevation is helpful in draining the fluid back towards the torso, where it can be absorbed and eliminated. Does he have a recliner where he can sit & elevate on a footrest, perhaps with a pillow underneath? You may need to get creative about placing (thin) support cushions, rolled towels, etc to ease his back.

Here is what I know about sitting versus lying down - too much lying down, or being inactive increases the risk of blood clots and pneumonia. So moving every 1/2 hour or hour, except during sleep, is highly recommended. Also, when sitting or lying down, ankle pumps, ankle circles and mild leg lifts (lightly assisted at first) should be done frequently. Also, he should be walking several times each day, with increasing distance from day to day

As for side sleeping - I understand - but does he have any restrictions about positioning of the operated leg? After about 2 weeks, I would lie on the non-operated side, with the upper leg bent & knee through ankle well supported by a firm pillow so it was elevated about 6-8".

Finally, you may be able to help with the swelling by doing some gentle "lymphedema massage" to the leg. You can find examples like this:

Thank you for the info - just helping my mother care for my father a bit. They live in a Northern community so it was a challenge to get from hospital back to their hometown both because of distance and weather at this time of year.
Thanks again