Post-Surgery Concerns: Hip Replacement and Varicose Veins

After a hemiarthroplasty, the varicose veins became more pronounced?

Dear Dr.
Lee,
I hope this message finds you well.
I am a 60-year-old patient who suffered a femoral neck fracture due to a fall.
The doctor recommended a partial hip replacement, and I have three questions post-surgery:
1.
Why was a total hip replacement not performed initially? With the partial replacement, will there be friction between the cartilage and the artificial joint, and will this wear lead to a need for a second surgery in the future?

2.
Before the surgery, the green veins in my leg were prominent, but one month post-surgery, I have developed bulging veins.
Could this be a sign of thrombosis? Should I return to the orthopedic clinic for evaluation, or should I consult a cardiothoracic surgeon?
3.
Following up on the previous question, what steps should I take to prevent further bulging of the veins?
Thank you for your assistance in addressing these concerns.
Best regards.

bobo, 30~39 year old female. Ask Date: 2019/06/12

Dr. Li Yongheng reply Orthopedics

1.
Femoral neck fractures that require a partial hip replacement are covered by health insurance regulations.
As long as excessive weight and overactivity are avoided, the likelihood of needing a second replacement due to wear is low.

2.
Postoperatively, due to poor muscle contraction and activity in the lower extremities, varicose veins may become more pronounced.
It is recommended to consult a cardiothoracic surgeon for evaluation.

3.
Reducing prolonged standing, wearing compression stockings, and performing calf raises for muscle strength training can help prevent the worsening of varicose veins.

Reply Date: 2019/06/12

More Info

Dear Patient,
Thank you for reaching out with your concerns following your hip replacement surgery. It’s completely understandable to have questions and worries after such a significant procedure. Let’s address each of your concerns in detail.

1. Why was a partial hip replacement chosen instead of a total hip replacement?
The decision to perform a partial hip replacement (hemiarthroplasty) instead of a total hip replacement (total hip arthroplasty) often depends on several factors, including the specific nature of the fracture, the condition of the surrounding bone and cartilage, and the overall health of the patient. In cases of a femoral neck fracture, if the blood supply to the femoral head is compromised, a partial replacement may be sufficient to restore function and alleviate pain. However, if the cartilage in the hip joint is severely damaged or if there are other underlying conditions, a total hip replacement might be more appropriate. Regarding wear and tear, while partial replacements can last many years, they may eventually require revision surgery due to wear on the remaining cartilage and the artificial components. Regular follow-ups with your orthopedic surgeon can help monitor the condition of your hip joint over time.

2. Is the appearance of prominent veins post-surgery a sign of blood clots?
The appearance of prominent veins, or varicose veins, following surgery can be concerning. Post-operative swelling and changes in circulation can lead to increased visibility of veins, especially if you had pre-existing varicosities. However, if you notice sudden changes, such as increased swelling, pain, or discoloration in your leg, it could indicate a more serious condition, such as deep vein thrombosis (DVT). It’s crucial to consult your healthcare provider to evaluate your symptoms. They may recommend an ultrasound to rule out blood clots. If blood clots are suspected, you may need to follow up with a vascular specialist or a cardiothoracic surgeon, depending on the severity and location of the clot.

3. What can be done to prevent further issues with varicose veins?
To manage and prevent worsening of varicose veins post-surgery, consider the following steps:
- Stay Active: Gentle movement and exercises can improve circulation. Avoid prolonged periods of sitting or standing.

- Compression Stockings: Wearing compression stockings can help reduce swelling and improve blood flow in your legs.

- Elevate Your Legs: When resting, elevate your legs to reduce swelling and improve circulation.

- Hydration and Diet: Staying hydrated and maintaining a healthy diet can support overall vascular health.

- Follow-Up Care: Regular check-ups with your healthcare provider are essential to monitor your recovery and address any concerns promptly.

In summary, it’s important to maintain open communication with your healthcare team regarding your recovery. They can provide tailored advice based on your specific situation and medical history. If you have any further questions or if your symptoms change, do not hesitate to reach out to your doctor. Your health and peace of mind are paramount.

Best wishes for your recovery,
Doctor Q&A Teams

[Your Contact Information]

Similar Q&A

Post-Surgery Hip Replacement: Understanding Pain and Swelling Concerns

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 thi...

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 phenom...

Understanding Pain and Complications After Hip Replacement Surgery

Dear Doctor, My father has undergone bilateral hip replacement surgery in the past two to three years (with surgeries performed on each hip separately). After the hip replacement, is it common for the affected area to experience pain, numbness, or loss of sensation? Could there...

Dr. Shi Guozheng reply Orthopedics
It is possible for the skin near the surgical wound to feel a bit numb, but this usually improves after some time. Muscle atrophy in the lower limbs may have already been present before the surgery, and if there is reluctance to move or if walking is not resumed quickly after the...

Post-Operative Concerns After Hip Replacement Surgery in Osteoporosis

Hello, doctor! My mother is 60 years old and has osteoporosis. Last year, she underwent a total hip arthroplasty on her left leg. However, less than two weeks post-surgery, she accidentally fell, causing the artificial hip joint to become misaligned. Now, she has significant exte...

Dr. Chen Yongxue reply Orthopedics
Hello, if an injury occurs shortly after surgery, causing a change in the angle of the artificial hip joint, it is still recommended to undergo revision surgery. However, repeating surgery in a short period increases the risk of infection. Whether the revision surgery can restore...

Post-Operative Hip Replacement: Addressing Nerve Pain and Recovery Concerns

After the mother underwent left total hip arthroplasty, she experienced numbness and pain on the outer side of her lower leg, and she is unable to dorsiflex her foot, although she can plantarflex and move her toes. The attending physician indicated that this might be due to a blo...

Dr. Shi Guozheng reply Orthopedics
1. It is possible that the sciatic nerve is being compressed, which can lead to an inability to dorsiflex the ankle joint. If the compression is not severe, recovery is possible. Currently, one option is to use a splint to maintain the ankle joint at a 90-degree angle. 2. After...