Post-Surgery Swelling After Tibial Plateau Fracture: Is It Normal? - Orthopedics

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Post-surgery swelling after a tibial plateau fracture is a common concern among patients, and it is essential to understand the healing process and what to expect during recovery. Given your situation, where you have undergone surgery involving the placement of plates, screws, and possibly bone grafting, it is not unusual to experience swelling, especially after prolonged periods of standing, sitting, or walking.

1. Understanding Swelling: After any surgical procedure, particularly those involving bones and joints, swelling is a natural response of the body. This swelling occurs due to inflammation, which is part of the healing process. The body sends extra blood and fluids to the area to promote healing, which can lead to noticeable swelling. In your case, the fact that your knee appears less swollen in the morning compared to later in the day indicates that the swelling is likely related to activity levels and gravity. When you are active, fluids can accumulate in the tissues around the knee, leading to increased swelling.

2. Normalcy of Symptoms: The symptoms you describe—swelling after prolonged activity and difficulty with movements like squatting—are typical for someone recovering from a tibial plateau fracture. It is essential to listen to your body; if you experience significant pain or swelling, it may be beneficial to rest, elevate your leg, and apply ice to reduce inflammation. Gentle range-of-motion exercises, as advised by your physical therapist or surgeon, can also help improve mobility and reduce stiffness.

3. Impact of Hardware Removal: Regarding your concern about the removal of the hardware (screws and plates) at the end of the year, it is important to discuss this with your orthopedic surgeon. In many cases, the removal of hardware can lead to a reduction in discomfort and swelling, especially if the hardware is causing irritation or is positioned in a way that affects your knee's function. However, the surgery itself may temporarily increase swelling as the body reacts to the new trauma of the procedure. Your surgeon will assess the condition of your knee and the surrounding tissues to determine the best course of action.

4. Long-term Considerations: It is crucial to continue with your rehabilitation exercises and follow your surgeon's recommendations. Engaging in physical therapy can help strengthen the muscles around your knee, improve stability, and enhance overall function. If you notice that your swelling is persistent or worsening, or if you experience new symptoms such as increased pain, redness, or warmth around the knee, it is essential to contact your healthcare provider for further evaluation.

5. When to Seek Help: If your symptoms do not improve with rest and conservative measures, or if you have concerns about the healing process, do not hesitate to reach out to your orthopedic surgeon. They may recommend imaging studies, such as X-rays or MRIs, to assess the healing of the fracture and the position of the hardware.

In summary, while post-surgery swelling can be concerning, it is often a normal part of the healing process after a tibial plateau fracture. Continue to monitor your symptoms, engage in prescribed rehabilitation, and maintain open communication with your healthcare team to ensure the best possible recovery.