Bruising after a Total Hip or Total Knee Replacement is normal. For some, the bruising can be mild, whilst for others the bruising can be extensive in nature.

After a Total Knee Replacement, some people may have bruising in the thigh, around the knee, down the shin, extending to the ankles and even toes.

In Total Hip Replacement, some people may have bruising around the suture line, into the buttock or groin. For some the bruising may extend down toward the knee, and for some even to the ankles/toes. Deep bruising may appear less intense and take longer to appear. A corked thigh sensation is something that is not uncommon after hip replacement.  This is due to deep bruising in the thigh muscle.

What is normal?

Below are photos of patients after Total Knee Replacement. Both are female, and not on any blooding thinning medications prior to surgery. The photos are taken at day 11 after surgery at the post-op appointment in the rooms.  (The bruising may have been more severe a few days earlier)

Whilst extensive bruising may seem ‘alarming’, it is also short term and normal. Differences as to why some people bruise more than others are varied, but can include- blood thinning agents (aspirin, warfarin, xarelto), the nature of surgery itself, skin tones & colourings, and areas of loose skin.  Additionally, some people have a propensity to bruise more easily.

Bruising usually begins to fade and disappear during week 2 after surgery.
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​Similarly you will notice the change in colour of the bruising- from deep red/purple, to greenish, to a yellowish type hue before fading completely.

​What can be done to expedite healing of bruising?

In the initial post operative phase applying ice can be beneficial. Ice should not be applied directly to the skin. A bag of frozen peas, or ice packs, in a pillowslip is ideal. Elevation of limbs is also helpful. These both help with the degree of swelling, which can help with discomfort after surgery.

Remember bruising is short term and normal. However, please contact the rooms if you have any concerns.

After surgery, normal sleeping and eating patterns can be altered.

​Why?

There are many theories as to what causes changes in sleep and appetite after surgery-

• the anaesthetic
• the surgery
• blood loss
• change in bowel habits
• fatique
• pain
• post operative medications
• change to normal routine after surgery.

In truth, it can be a combination of all or none of these theories.
Generally speaking, there is nothing to be alarmed about.
It is more important to eat small, regular, light meals.  Ensure that you have adequate fluid intake. Avoid coffee or tea in the evenings.  Take the prescribed painkillers if it is difficult to get comfortable. It is often better to take these medications prior to going to bed, rather than spending the night being uncomfortable and unsettled.

If people aren’t sleeping reasonably when we see them at 12 days after surgery, we often prescribe a tablet for nerve pain that also works as a mild sedative, getting the sleep/wake cycle back on track.

In time things should return to normal, but in the interim try not to dwell too much on these changes and focus on getting back to life.