Managing Muscle Soreness and Swelling After Knee Replacement Surgery

Postoperative soreness and swelling after knee replacement surgery?

Dear Vice President Wang,
My mother is 69 years old and underwent bilateral knee replacement surgery at Taipei Veterans General Hospital in early March.
She had her stitches removed three days ago.
Although she does not experience pain post-surgery, she has been troubled by muscle soreness and swelling around the surgical site since the operation.
The knee incision and surrounding area are swollen, which can be alleviated with ice packs.
However, her thigh and calf muscles are very sore, and we have not found any effective methods to relieve this discomfort.
She struggles to sleep at night, waking up every couple of hours due to soreness, and she sits up to rub her legs (as squeezing them causes more pain), which is truly heartbreaking to witness.
During the day, she gets out of bed every 1 to 2 hours to walk for about 5 to 10 minutes, and I assist her with knee flexion rehabilitation exercises daily.
The pain medication prescribed by the hospital only alleviates pain but does not address muscle soreness.
I am wondering if there are any other methods to help reduce her leg muscle soreness? Currently, we apply a warm towel to her calves before bed, but the effect seems limited.

Ms. Hsu, 40~49 year old female. Ask Date: 2018/03/26

Dr. Wang Huijun reply Rehabilitation

Dear Ms.
Hsu,
Your mother's symptoms are common after surgery, and your current management approach is correct.
Typically, the resolution of symptoms occurs gradually.
Considering that it has been about a month since your mother's surgery, the fact that she only experiences soreness without significant pain is a positive sign of recovery.
However, since she is 70 years old and had surgery on both legs simultaneously, her recovery may be slower.
Gentle massage of the thighs is acceptable, and I recommend using a topical analgesic for better results.
The rehabilitation exercises you are doing are also appropriate, but it's important to proceed at a manageable pace and avoid rushing.
You might consider purchasing an electric blanket for heat therapy, which can be beneficial as well.
If her sleep is significantly affected, administering pain relief medication is also acceptable, as prolonged pain or sleep disturbances can be a strain on elderly individuals.
If her condition does not improve, I suggest bringing her back for a follow-up appointment with her surgeon or a rehabilitation specialist.
Wishing your mother a speedy recovery.

Reply Date: 2018/03/26

More Info

Managing muscle soreness and swelling after knee replacement surgery can be a challenging process, especially for elderly patients. Your mother’s experience of muscle soreness and swelling post-surgery is not uncommon, and there are several strategies that can help alleviate these symptoms.

Firstly, it’s important to understand that after a knee replacement surgery, the body undergoes significant trauma, and the healing process can lead to muscle soreness and swelling. The muscles around the knee, particularly in the thigh and calf, may become sore due to disuse and the surgical procedure itself. This soreness can be exacerbated by the swelling that often occurs after surgery.

1. Ice Therapy: You mentioned that ice packs have been helpful for the swelling around the knee. Continuing to use ice therapy is beneficial. Applying ice for 15-20 minutes every couple of hours can help reduce swelling and numb the soreness. Make sure to wrap the ice pack in a cloth to prevent frostbite.

2. Elevation: Elevating the legs can also help reduce swelling. Encourage your mother to keep her legs elevated above the level of her heart when resting. This can be done using pillows or a recliner.

3. Gentle Movement: While it’s great that she is walking every 1-2 hours, it’s also important to incorporate gentle stretching and range-of-motion exercises. These exercises can help maintain flexibility and reduce stiffness. However, they should be done carefully and within her comfort level to avoid exacerbating soreness.

4. Heat Therapy: While you’ve tried using a warm towel, consider using a heating pad or a warm bath. Heat can help relax tight muscles and improve blood flow, which may alleviate soreness. However, heat should be used cautiously and not immediately after ice therapy.

5. Massage: Gentle massage around the sore areas can help improve circulation and reduce muscle tightness. If she finds that kneading is too painful, light strokes may be more comfortable.

6. Over-the-Counter Pain Relief: If the prescribed pain medication is not addressing the soreness, consider discussing with her physician the possibility of using over-the-counter medications like acetaminophen or ibuprofen, which can help with both pain and inflammation.

7. Physical Therapy: If she hasn’t already, enrolling in a physical therapy program can be very beneficial. A physical therapist can provide tailored exercises that promote healing and strengthen the muscles around the knee without causing excessive strain.

8. Hydration and Nutrition: Ensuring that she stays well-hydrated and consumes a balanced diet rich in vitamins and minerals can support the healing process. Foods high in protein, omega-3 fatty acids, and antioxidants can be particularly beneficial.

9. Sleep Hygiene: Since your mother is having trouble sleeping due to discomfort, consider creating a comfortable sleep environment. This may include using supportive pillows, maintaining a cool room temperature, and establishing a calming bedtime routine.

10. Consultation with Healthcare Providers: If the soreness persists or worsens, it’s crucial to consult her healthcare provider. They may need to evaluate her condition further to rule out any complications such as infection or deep vein thrombosis (DVT).

In summary, managing muscle soreness and swelling after knee replacement surgery involves a combination of ice and heat therapy, gentle movement, proper elevation, and possibly medication adjustments. It’s essential to monitor her symptoms and maintain open communication with her healthcare team to ensure a smooth recovery process. With time and appropriate care, her discomfort should gradually improve, allowing her to regain strength and mobility.

Similar Q&A

Managing Swelling and Pain After Knee Replacement Surgery

Hello, Director Su! The elderly lady had a knee arthroplasty two months ago, and her knee is still red and swollen. Can she apply ice to the swollen area around the artificial joint? Will this affect her walking in the future? Is rehabilitation possible? Thank you!

Dr. Su Hongci reply Rehabilitation
Degenerative arthritis is currently the most common reason for performing total joint replacement surgery. Knee osteoarthritis is a slowly progressive joint disease associated with aging, joint injuries, genetics, individual constitution, obesity, and overuse, typically occurring...

Managing Swelling and Blood Issues After Joint Replacement Surgery

Post-operative swelling in the calf and foot after joint replacement surgery should be managed by following these steps: 1. Elevation: Keep the affected leg elevated above heart level to reduce swelling. 2. Compression: Use compression stockings or bandages as recommende...

Dr. Chen Yongxue reply Orthopedics
The bruised area can start to improve with warm compresses five days after surgery, and the swelling should subside in about two weeks. However, some swelling may persist for a longer duration, especially around the knee joint, which can last up to six months. In the short term, ...

Managing Post-Operative Pain and Weakness After Knee Replacement Surgery

My mother had a knee replacement surgery in March of this year, and it has been nearly six months since then. However, she still experiences 1) severe pain (sharp pain) at times, 2) weakness while walking and a feeling of the knee giving way, 3) stiffness in the knee and calf, an...

Dr. Shi Guozheng reply Orthopedics
The most likely cause of pain after total knee arthroplasty is infection, followed by loosening of the implant. If neither of these is the cause, it may be due to insufficient rehabilitation, muscle weakness, or poor range of motion, leading to mobility issues. A blood test can b...

Managing Knee Muscle Soreness After Job Change: Tips and Solutions

I previously worked in a job that required standing for long periods. After changing jobs, I often have to squat and stand up repeatedly, as well as lift heavy objects weighing several dozen kilograms. Since switching jobs, I frequently experience a sensation of soreness in my kn...

Dr. Chen Wayda reply Rehabilitation
Physical therapy can be performed for a quicker recovery.