Swollen Ankle after Anterior Hip surgery

Posted by vivuscraig @vivuscraig, May 31, 2022

I had surgery 7 days ago. My swelling has been minimal. I have been walking and doing exercises. I have been applying ice and keeping my feet above my heart when not moving.

Yesterday, during a friends visit, I sat in a regular chair for 2.5 hours. After the visit my surgical leg and ankle were very swollen. After icing and elevating in the evening and overnight, the swelling did decrease some.

However, after doing just a little activity today, my ankle balloons up again. I am elevating and icing but the ankle is very slow to respond.

Is this normal? Should I avoid activity while it is swollen? Thank you in advance.

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@pvctom2021

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

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I think everyone’s recovery is at a different rate. I felt like I failed when at 6 weeks I still was far from recovered. I kept on with PT and elevation, however. At 3 and a Half months I finally feel mostly recovered. I just gave up a came a week ago. I was able for the first time to get into the drivers seat of our van and drive again yesterday. I had extreme swelling for a couple of months in spite of compression stockings, elevation and icing. It takes a lot of patience and persistence. At one point I did too much and caused more pain. I backed off activity some and added more rest and it paid off in a few weeks. Best wishes for a Good recovery no matter how long it takes.

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I have had both hips replaced using the anterior approach. I had significant swelling in my whole leg including the ankle. The left one was don July 1 and I still have some swelling but it’s getting better. Had the right one done Nov 1 with same swelling. I completely agree with Sue and encourage your dad to do ankle pumps and walking. That is the best thing to do while awake.
I sleep with pillows under my knees and also wear compression socks during the day. Really helps to remember this is major surgery and it will take a lot of time and patience to get back to normal. The booklet I got from my Mayo surgeon said it takes a year.
Also, I recommend PT if that is available to them. I have safe exercises to do there and at home. BTW, I am 77.

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@queenie2030

I think everyone’s recovery is at a different rate. I felt like I failed when at 6 weeks I still was far from recovered. I kept on with PT and elevation, however. At 3 and a Half months I finally feel mostly recovered. I just gave up a came a week ago. I was able for the first time to get into the drivers seat of our van and drive again yesterday. I had extreme swelling for a couple of months in spite of compression stockings, elevation and icing. It takes a lot of patience and persistence. At one point I did too much and caused more pain. I backed off activity some and added more rest and it paid off in a few weeks. Best wishes for a Good recovery no matter how long it takes.

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Thanks so much…🙏

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@sueinmn

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:


Good luck helping Dad recuperate.
Sue

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Hello - I’m at week 1 - post labrum tear/ FIA hip Arthroscopic. Noticed my entire leg is a bit pinkish and swollen. I’d like to think is due to a response to the shock of surgery and not thing to do to with blood clot.

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Hip replacement was accompanied by normal ankle swelling. After 18 months ankle is still swollen. My cardiologist did Venal compression tests that proved negative. My foot specialist did series of Cortisone shots that were ineffective. I have been on a diuretic and potassium script for a year to date. It helps a little but by the afternoon my ankle is pretty swollen. Next week I see my orthopaedic doctor who did the surgery. Maybe he has experience with prolonged swelling in other patients? I hope so. I need some answers.

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I had an anterior hip replacement on my right leg almost 3 years ago now and the ankle of that leg stays swollen. I’ve had scans and X-rays and no blood clot or injury was found. Is it possible that the ankle is swelling because of the hip replacement years after?

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Hello, All,

I have LTHR in March 2023. Within the first week, I had excruciating nerve pain around left knee, so bad that even if the sheet touched there, it was on fire. I was assured it would resolve in a few months. Well, it is now July 2024 and it is not fully resolved, but I suppose the "good news" is that it is "only" numb with some nerve pain on contact above the knee. Ortho said 18 months should resolve but will be left with numbness. Ok

Now as to the ankle swelling. I could not see the back of my body after surgery but my sister helped me shower and said the back of my left thigh looked black and blue. She took photos, and indeed black and blue. Although my ankle did not seem to swell, I have purple veins around the left ankle area, and the color of my left leg looks different than the right (the left is kind of "bluish" looking). At last appointment in March (1 year) with ortho, he casually said those symptoms were venous but did not seem concerned.
This THR is very serious stuff, and sometime you swap the witch for the devil. Now my right hip has begun hurting in past week, and I already know where that is heading. It is painful during certain movements (OUCH), but I am going to try to delay THR until worsens because I dread going through this again. I've started taking Meloxicam, think it helps pain some and continue to do exercises and walk. Movement is always the best thing to do.
BTW, it was about 4 months before I could tolerate getting in the car to drive and had to sell my sweet convertible and purchase a higher vehicle SUV, works better now. I am thankful that the left THR - structurally - seems stable and sound (X-rays ortho says perfect).
I am 76, and I believe age certainly makes a big difference as well as so many other factors. My sister age 74 had a THR last fall (at Steadman in CO) and she was on an airplane within a month and has sprung back into action. But she was a yoga addict for the past 25 years, is an amazing cook all fresh foods, so she was in much better shape than I.
Well, it is what it is. On this second THR, I am considering a change in ortho but again may do the swap to worse and that make me fearful. My mom used to say with good humor but truthfully, "gettin' old is hell." It sure ain't no picnic. smile
I feel for all the older people who undergo these surgeries.

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@mackad2024

Hello, All,

I have LTHR in March 2023. Within the first week, I had excruciating nerve pain around left knee, so bad that even if the sheet touched there, it was on fire. I was assured it would resolve in a few months. Well, it is now July 2024 and it is not fully resolved, but I suppose the "good news" is that it is "only" numb with some nerve pain on contact above the knee. Ortho said 18 months should resolve but will be left with numbness. Ok

Now as to the ankle swelling. I could not see the back of my body after surgery but my sister helped me shower and said the back of my left thigh looked black and blue. She took photos, and indeed black and blue. Although my ankle did not seem to swell, I have purple veins around the left ankle area, and the color of my left leg looks different than the right (the left is kind of "bluish" looking). At last appointment in March (1 year) with ortho, he casually said those symptoms were venous but did not seem concerned.
This THR is very serious stuff, and sometime you swap the witch for the devil. Now my right hip has begun hurting in past week, and I already know where that is heading. It is painful during certain movements (OUCH), but I am going to try to delay THR until worsens because I dread going through this again. I've started taking Meloxicam, think it helps pain some and continue to do exercises and walk. Movement is always the best thing to do.
BTW, it was about 4 months before I could tolerate getting in the car to drive and had to sell my sweet convertible and purchase a higher vehicle SUV, works better now. I am thankful that the left THR - structurally - seems stable and sound (X-rays ortho says perfect).
I am 76, and I believe age certainly makes a big difference as well as so many other factors. My sister age 74 had a THR last fall (at Steadman in CO) and she was on an airplane within a month and has sprung back into action. But she was a yoga addict for the past 25 years, is an amazing cook all fresh foods, so she was in much better shape than I.
Well, it is what it is. On this second THR, I am considering a change in ortho but again may do the swap to worse and that make me fearful. My mom used to say with good humor but truthfully, "gettin' old is hell." It sure ain't no picnic. smile
I feel for all the older people who undergo these surgeries.

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I fully understand what you are saying. I just had my 4th joint replacement 7 weeks ago at age 77. It was a reverse shoulder replacement since I fell and broke my arm in two places and damaged the rotator cuff. I am doing extremely well and could not be happier, completely pain free in my new shoulder. I have also had both knees replaced and one hip. I have decided I think a lot depends on the talent of the surgeon who does your replacement. This time I got what was told to me by another of my doctors was the best shoulder surgeon in a large city and does all the complex cases. The physical therapist you have can also make a lot of difference in your recovery. Some are too aggressive with us older people. Mine has been perfect for the last two surgeries. It also helps to do your exercises everyday even when you don't have therapy. It took me a long time to be able to get into our van after my hip surgery but I kept stretching and trying and finally got in about 4 months after hip replacement. I am able to drive this time 6 weeks after shoulder replacement. Best of luck and don't forget the reduced pain and mobility are worth all the hassle of surgery.

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@queenie2030

I fully understand what you are saying. I just had my 4th joint replacement 7 weeks ago at age 77. It was a reverse shoulder replacement since I fell and broke my arm in two places and damaged the rotator cuff. I am doing extremely well and could not be happier, completely pain free in my new shoulder. I have also had both knees replaced and one hip. I have decided I think a lot depends on the talent of the surgeon who does your replacement. This time I got what was told to me by another of my doctors was the best shoulder surgeon in a large city and does all the complex cases. The physical therapist you have can also make a lot of difference in your recovery. Some are too aggressive with us older people. Mine has been perfect for the last two surgeries. It also helps to do your exercises everyday even when you don't have therapy. It took me a long time to be able to get into our van after my hip surgery but I kept stretching and trying and finally got in about 4 months after hip replacement. I am able to drive this time 6 weeks after shoulder replacement. Best of luck and don't forget the reduced pain and mobility are worth all the hassle of surgery.

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Queenie,

Thank you for your kind message. My ortho for the LTHR is the Director of Adult Hip and Knee Surgery at the Charlotte Atrium Hospital. He has distinguished credentials and is experienced. The hip is good, but the thigh numb/nerve issue is something I didn't expect. Hopefully, it will resolve. So I am considering him - again, or searching for another highly qualified ortho. You sound like you are doing very well. Keep it up!!
Thank you

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I forgot to tell you my thigh is still numb 11 months after my total hip replacement. Perhaps the nerves that were cut will grow back but who knows. When I touch my thigh it doesn’t feel like it is my leg. Like I am touching an artificial limb. My hip pain relief is so wonderful I will happily live with a numb thigh. Also my ankle on that hip side still swells after almost a year. I feel like people who don’t need joint replacements are very fortunate. Hope all goes well for you. I need my other shoulder replaced but think I will wait until next year.

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