Leg and Ankle Swelling After Hip Replacement: Causes and Management

Post‑operative lower extremity edema is common but may signal complications.

Common Causes

• Dependent positioning: Gravity‑dependent fluid accumulation.
• Lymphatic disruption: Surgical dissection impairs drainage.
• Inflammatory response: Tissue trauma → capillary leakage.
• Reduced mobility: Calf pump inactivity → venous stasis.

Concerning Causes (Require Urgent Evaluation)

• Deep vein thrombosis (DVT): Unilateral swelling, calf pain, warmth, erythema. Diagnose with duplex ultrasound.
• Infection: Increasing pain, erythema, fever, wound drainage.
• Heart/kidney/liver dysfunction: Systemic fluid overload.

Management

• Elevate leg > heart level frequently.
• Compression stockings (20–30 mmHg) during day.
• Ankle pumps, early ambulation.
• Ice for inflammatory component.
• Diuretics only if systemic overload confirmed.
• Anticoagulation per protocol (usually 10–35 days) for DVT prophylaxis.

Report asymmetric or worsening swelling to your surgical team promptly.