Post-Surgery Hip Replacement: Pain and Swelling Concerns

Hip joint replacement with a partial prosthesis due to a fall fracture?

Hello Doctor: My mother suffered a fall and fractured her hip.
The doctor determined that she needed a partial hip replacement, which she underwent three weeks ago.
However, she is experiencing sharp pain in her groin and knee, and her groin area feels very tight and hard.
Is this a normal post-operative phenomenon? Additionally, her foot is still significantly swollen.
What can be done to reduce the swelling? Thank you.

Ms. H, 20~29 year old female. Ask Date: 2019/05/07

Dr. Li Yongheng reply Orthopedics

Hello, it has been three weeks since the surgery, and I am experiencing sharp pain in the groin and knee, along with tightness and hardness in the groin area.
These are normal postoperative symptoms.
Currently, my foot is still swollen, which is also a normal postoperative phenomenon.
Generally, these discomforting symptoms improve within three months after surgery.
Elevating the leg with a pillow, along with massage and movement of the lower extremities, can help reduce the swelling.

Reply Date: 2019/05/07

More Info

Post-surgery pain and swelling after a hip replacement can be concerning for both patients and their families. It is important to understand that some level of discomfort and swelling is common after such a significant surgical procedure. Here’s a detailed overview of what you might expect and some recommendations for managing these symptoms.

Firstly, it is not unusual for patients to experience pain in the groin area and knee after hip replacement surgery. This pain can be attributed to several factors, including surgical trauma, inflammation, and the body’s healing process. The tightness and hardness you describe in the groin area may be due to swelling and muscle tension as the body adjusts to the new joint. The hip joint is surrounded by muscles, tendons, and ligaments that may become inflamed or irritated during surgery, leading to discomfort.
The pain you mention, particularly if it feels like a sharp or shooting sensation, could also be related to nerve irritation or compression. During surgery, the positioning of the leg and the manipulation of tissues can sometimes irritate nearby nerves, leading to sensations of pain or tightness. This is often temporary and should improve as healing progresses.

Regarding the swelling in the foot, it is common for patients to experience edema (swelling due to fluid retention) after hip replacement surgery. This can be exacerbated by immobility, as the body’s circulation may be less efficient when a person is less active. To help reduce swelling, here are some strategies:
1. Elevation: Keeping the leg elevated above the level of the heart can help reduce swelling. Use pillows to prop up the leg while resting.

2. Compression: Wearing compression stockings or wraps can help promote circulation and reduce swelling. Be sure to follow your doctor’s recommendations regarding the type and duration of use.

3. Movement: Gentle movement and exercises, as advised by a physical therapist, can help improve circulation and reduce swelling. Simple ankle pumps and leg lifts can be beneficial.

4. Cold Therapy: Applying ice packs to the swollen areas can help reduce inflammation and numb the pain. Be sure to wrap ice packs in a cloth to prevent skin damage.

5. Hydration: Staying well-hydrated can help your body manage fluid levels more effectively.

6. Medication: Over-the-counter pain relievers or anti-inflammatory medications, as prescribed by your doctor, can help manage pain and reduce swelling.

It is essential to communicate with your mother’s healthcare team regarding her symptoms. If the pain or swelling worsens or does not improve with these measures, it may be necessary to evaluate for complications such as infection, blood clots, or other issues that may require medical intervention.

In summary, while some pain and swelling are expected after hip replacement surgery, it is crucial to monitor these symptoms closely. Encourage your mother to follow her rehabilitation plan, stay active within her limits, and maintain open communication with her healthcare providers to ensure a smooth recovery. If there are any concerns about her symptoms or if they seem unusual, do not hesitate to reach out to her surgeon or physical therapist for further evaluation and guidance.

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