Knee replacement surgery is a common procedure performed to alleviate severe joint pain and improve mobility. It involves replacing damaged bone and cartilage with artificial components. Bruising is a common aspect of recovery following this type of surgery. While extensive discoloration can be concerning, it is a normal part of the healing journey.
Understanding Post-Surgery Bruising
Bruising after knee replacement occurs due to the surgical process. The procedure requires cutting through soft tissues and bone to access and replace the knee joint, which inevitably disrupts small blood vessels. This disruption allows blood to leak out from the capillaries and collect under the skin, leading to the visible discoloration known as a bruise or hematoma.
A tourniquet is often used during knee replacement surgery to minimize blood loss, which can also contribute to bruising, particularly in the thigh area where it is applied. Additionally, patients are frequently prescribed blood-thinning medications after surgery to prevent blood clots, and these can increase the likelihood and extent of bruising by making it harder for blood to clot and contain the leakage. Individual factors, such as age and skin condition, also play a role in how easily and extensively a person might bruise.
Typical Appearance and Duration
Bruising after knee replacement can present with a variety of colors as it evolves. Initially, the bruise may appear red, purple, or blue, gradually transitioning to shades of green, yellow, and brown as the blood pigments break down during healing. The discoloration often extends beyond the immediate surgical site, sometimes tracking down the leg towards the ankle or even the foot. This downward spread is a result of gravity pulling the fluid and blood downwards. Swelling commonly accompanies bruising in the postoperative period and is also a normal response to the trauma of surgery.
Bruising begins to fade and resolve within one to two weeks after surgery. Bruising can persist for two to three weeks, and in some cases, up to four to six weeks, gradually diminishing. Deep bruising may also take longer to appear and resolve.
Signs That Require Medical Attention
While bruising is a normal part of recovery, certain signs may indicate a potential complication and warrant medical attention. A sudden, severe increase in pain or swelling around the surgical site or extending down the leg requires prompt evaluation. If the bruising is rapidly expanding or becomes unusually large, it may signal an underlying issue. Any new or worsening redness or warmth around the incision that appears to be spreading is concerning.
If the bruising is accompanied by a fever or chills, or if there is any oozing or pus from the wound, seek medical advice. Sharp pain or tenderness in the calf or groin regions, especially if new or increasing, could indicate a blood clot and requires immediate assessment. If the discoloration does not subside within the expected timeframe, or if swelling becomes red and expands significantly below the knee, contact your surgeon.