Post-Operative Swelling After Knee Osteotomy Surgery

Q: Post-Operative Swelling After Knee Osteotomy Surgery

Hello： It is not necessarily a problem if the swelling has not subsided more than a month after surgery. <br>Just be sure to monitor for any signs of surgical infection (such as： tingling, fever). <br>If there is severe osteoporosis, be cautious with movements to avoid falls and

Hello, doctor. I would like to discuss knee osteotomy surgery?

Hello Doctor, due to a car accident many years ago, I did not receive proper treatment at the time, which has led to a deformity of 17 to 19 degrees of valgus in my right knee (X-shaped leg, but only on the right side).
In August of this year, I underwent an osteotomy surgery, where the knee was opened, and a graft from another person was placed.
Above the knee, I have a rod and plate installed along half of my thigh.
It has now been one and a half months, and my knee has not reduced in swelling and is still as large as a baseball.
I can bend it to about 90 degrees, and I am still working hard every day to bend my knee and straighten it.
I would like to ask if it is normal for the surgical site to remain swollen one and a half months post-surgery? Additionally, I have severe osteoporosis due to a rare disease.
What else should I pay attention to? Thank you for taking the time to read my question, I really appreciate it! Thank you for your hard work!

Ching, 30~39 year old female. Ask Date: 2015/10/10

Dr. Wang Shouji reply Orthopedics

Hello: It is not necessarily a problem if the swelling has not subsided more than a month after surgery.
Just be sure to monitor for any signs of surgical infection (such as: tingling, fever).
If there is severe osteoporosis, be cautious with movements to avoid falls and do not exert yourself excessively to prevent further fractures.
Thank you!

Reply Date: 2015/10/10

More Info

Post-operative swelling after knee osteotomy surgery is a common concern, especially in the context of significant surgical interventions like the one you described. Given your history of a car accident leading to a deformity and the subsequent surgical correction, it is understandable that you have questions about the swelling and recovery process.

Firstly, it is important to recognize that swelling is a normal part of the healing process following any surgical procedure, particularly one involving the knee joint. The knee is a complex structure, and surgeries like osteotomy can lead to inflammation as the body responds to trauma. This inflammation is part of the healing process, but it can also lead to discomfort and limitations in mobility.

In your case, having undergone an osteotomy where bone grafting was involved, along with the placement of screws and plates, the swelling you are experiencing is not unusual. The presence of hardware can also contribute to localized swelling and discomfort. Typically, swelling can persist for several weeks to months post-surgery, depending on the extent of the procedure and individual healing responses.

Regarding your specific concerns:
1. Duration of Swelling: At one and a half months post-surgery, it is not uncommon for swelling to still be present. While some patients may see a reduction in swelling within a few weeks, others may take longer, especially if there were complications or if the surgery was extensive. It is essential to continue monitoring the swelling and report any significant changes to your healthcare provider.

2. Range of Motion: Achieving a range of motion of about 90 degrees at this stage is a positive sign, but it is crucial to continue working on your rehabilitation exercises. Gentle stretching and strengthening exercises, as advised by your physical therapist, will help improve your knee's flexibility and strength over time. However, be cautious not to push through severe pain, as this can lead to further complications.

3. Bone Density Considerations: Given your history of severe osteoporosis, it is vital to take extra precautions during your recovery. Osteoporosis can affect bone healing and increase the risk of complications such as fractures. Ensure that you are following any dietary or medication recommendations from your healthcare provider to support bone health. Weight-bearing exercises may need to be approached with caution, and you should consult your doctor or physical therapist regarding the best strategies for safely increasing your activity level.

4. Managing Swelling: To help manage the swelling, consider the following strategies:
- Elevation: Keep your leg elevated above the level of your heart when resting to reduce swelling.

- Ice Therapy: Applying ice packs to the swollen area can help reduce inflammation and provide pain relief. Use ice for 15-20 minutes several times a day, ensuring you have a barrier between the ice and your skin.

- Compression: Wearing a compression bandage or knee sleeve can help control swelling and provide support.

- Gentle Movement: Engage in gentle range-of-motion exercises as tolerated, as this can help promote circulation and reduce swelling.

5. Follow-Up Care: Regular follow-up appointments with your orthopedic surgeon are crucial. They can assess your healing progress, adjust your rehabilitation plan, and address any concerns regarding your swelling or pain levels. If the swelling does not improve or worsens, or if you experience increased pain, redness, or warmth, it is essential to seek medical attention promptly, as these could be signs of complications such as infection or blood clots.

In summary, while persistent swelling at one and a half months post-knee osteotomy can be concerning, it is often a normal part of the healing process. Continue to engage in your rehabilitation exercises, manage swelling with appropriate strategies, and maintain open communication with your healthcare team to ensure a successful recovery.

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