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How long does swelling after hip or knee replacement last?
Swelling is part of healing after any joint replacement. It usually peaks in the first week or two, then settles gradually over the following weeks and months.
Knee swelling gets talked about more than hip swelling, and for a simple reason: the knee sits just under the skin, so you can see and feel every bit of it. The hip is a deep joint, surrounded by muscle, so its swelling is harder to see. But a hip can stay mildly swollen for several months too.
Some knees take longer. What I tell patients is that roughly one in 50 knees still has some activity-related swelling and aching two years after surgery. That is not the usual course, but it is not a sign of failure either.
Why does the bruising spread down my leg?
The bruising worries people more than almost anything else, and it is usually harmless. During surgery, there is some bleeding around the joint. Over several days, that blood slowly moves down the leg under the skin, following gravity.
So at two weeks, the bruise may look impressive: purple and yellow down the shin, even around the ankle, far from the incision. That is the blood from surgery showing up on the skin on its way to being reabsorbed. Bruising tends to be more noticeable if you take a blood thinner.
“The bruising tends to concern people. What’s actually happening is bleeding around the surgery site slowly moving down the leg to the skin, and that takes several days. So at two weeks, the bruising down the shin and ankle can look quite impressive in some people. It is usually a normal part of healing.”
Is swelling in my foot and ankle normal?
Some swelling in the foot and ankle is normal after a knee or hip replacement. The test is whether it responds to elevation.
- Usually normal: swelling that builds when you are up and active, then goes down when you raise the leg. It should be noticeably less in the morning after lying flat all night.
- Worth a call: swelling that keeps getting worse, swelling that does not go down with elevation, or any swelling that comes with calf pain.
What actually brings the swelling down?
Ice. Ice with a cloth barrier between the cold and your skin, every time, especially after walking and exercise, when the knee swells the most. A large review of 140 studies found that cold therapy during the first two weeks after knee replacement was consistently associated with less swelling.[1] The details are in how to ice after knee replacement.
Elevation, done properly. The key is getting your ankle above the level of your heart. Propping your foot on a stool while you sit in a recliner does not do that. To really elevate, you have to lie down, with pillows under the whole leg so the ankle sits higher than your chest.
To really elevate, lie back so your ankle sits above the level of your heart.Compression stockings for the first two weeks. That is when swelling is building. After a knee replacement we use thigh-high stockings that come up over the knee; after a hip replacement, knee-high stockings.
Not overdoing it early. Your body is healing, and too much too soon feeds the swelling. In the first week or two I follow what I call the quiet knee protocol: let the swelling settle before pushing harder.
Anti-inflammatory medicine, if your surgeon has it in your plan, can help with swelling too. It is an addition to ice, elevation and stockings, not a replacement for them.
“Ice, elevation and two weeks of stockings are the mainstay. The key is that the ankle is above the level of the heart, and to really do that well, you have to be lying down. And don’t overdo it early on. Your body is healing.”
Why does swelling matter for my recovery?
A swollen knee is a tight knee. Swelling makes it harder to bend and straighten, and it is one of the main reasons motion stalls in the early weeks. Getting it under control is what makes the rest of your range of motion work possible. After a hip replacement, swelling adds to the soreness in the thigh and groin that is common in the first weeks; more on that in hip replacement pain.
Is it swelling, a blood clot, or an infection?
Most swelling after joint replacement is normal. But swelling is also a sign of two things you should never wait out.
A blood clot in the leg can cause swelling. Call right away for:
- Calf pain, tenderness, warmth, or redness
- Swelling in one leg that keeps getting worse or does not go down with elevation
Sudden shortness of breath or chest pain is an emergency. Call 911.
An infection can also show up as swelling. Call right away for:
- Redness spreading around the incision
- Drainage from the incision, or an incision that opens
- A fever above 101.5 degrees Fahrenheit
“If you’re worried, I’m worried. If something about your swelling concerns you and it isn’t on this list, reach out. Calling is better than going straight to the ER.”
Our clinic number is answered 24 hours a day; after hours it reaches the on-call provider.
What about swelling that is not from surgery?
If your knee is swollen and you have not had a replacement, the causes are different. See knee swelling that is not from surgery.
Joint replacement recovery in Franklin, Nashville, and Middle Tennessee
I perform hip and knee replacements at the Bone and Joint Institute of Tennessee in Franklin, on the Williamson Health campus, for patients from Franklin, Brentwood, Nashville, Spring Hill, Nolensville, Murfreesboro, and across Middle Tennessee. Swelling is one of the things we watch closely at every follow-up visit.
This article is for educational purposes only and does not replace personalized medical advice. Recovery instructions vary by individual health factors; always follow the guidance of your own surgical team. In an emergency, call 911.
References
- McGarry L, Kearney J, Rotaru J, Gunaratne R. Swelling management in total knee arthroplasty: a systematic review. JBJS Rev. 2025;13(9). doi:10.2106/JBJS.RVW.25.00109
