Total knee replacement (TKR) surgery is a common procedure that helps many regain mobility and reduce pain. Swelling around the knee is a normal and expected part of recovery. This swelling reflects the body’s natural healing response as it repairs tissues involved in the operation. Understanding this reaction helps manage rehabilitation expectations.
The Typical Swelling Timeline
Swelling after total knee replacement typically follows a predictable timeline, though individual experiences may vary. Initially, moderate to severe swelling is common in the first few days or weeks after surgery, often peaking within three days. Bruising around the knee can also be present during this acute phase and usually lasts one to two weeks.
Swelling gradually decreases over subsequent weeks and months. By four to twelve weeks post-surgery, swelling should continue to reduce, though it might still be noticeable after increased activity. Mild to moderate swelling can persist for three to six months, and for some individuals, complete resolution may take up to a year or even longer. This prolonged, mild swelling is often a normal part of the body’s long-term healing and remodeling of the joint.
Understanding Post-Surgical Swelling
The presence of swelling after knee replacement surgery is a physiological response to the surgical process. During the procedure, tissues, blood vessels, and bones are cut to facilitate the implantation of new joint components. This trauma triggers an inflammatory response, sending fluid and immune cells to the surgical site for healing.
Fluid accumulation, known as edema, occurs as lymphatic and blood vessels are temporarily disrupted, leading to fluid buildup in the joint and surrounding tissues. Gravity can also contribute to fluid pooling in the lower extremity, especially when the leg is in a dependent position. This combination of inflammation, fluid buildup, and gravitational effects results in the observable swelling.
Strategies for Swelling Management
Managing swelling is an important part of recovery after total knee replacement. Elevating the affected leg above heart level helps to reduce fluid accumulation by assisting gravity in draining fluid back towards the body. This is achieved by propping the leg on pillows, ensuring the ankle is higher than the knee, and the knee is higher than the hip.
Applying ice therapy to the knee can reduce swelling and inflammation. Ice packs or cold therapy devices should be applied for 15 to 20 minutes, several times daily, with a cloth barrier to protect the skin. Compression stockings or bandages also help control swelling by providing external pressure.
Gentle, prescribed movements and exercises, guided by a physical therapist, improve circulation and reduce stiffness. Activities like ankle pumps stimulate calf muscles, promote fluid drainage, and aid in preventing blood clots. Prescribed anti-inflammatory or pain medications can manage discomfort associated with swelling.
When to Seek Medical Attention
While some swelling is normal, certain signs may indicate a complication requiring medical attention. A sudden increase in swelling, especially if it does not improve with rest and elevation, should be promptly evaluated. Swelling with severe or worsening pain not relieved by prescribed medication is a concern.
Signs of infection include localized redness, increased warmth around the knee, fever, or chills. Calf pain or tenderness, especially with swelling in the calf or foot, could indicate a deep vein thrombosis (DVT). New numbness or tingling sensations, or swelling that worsens despite management, warrants immediate medical consultation.