Swelling After a Hip Replacement: What's Normal and How to Manage It

Swelling after a hip replacement is normal, expected, and almost always part of healing rather than a sign that something has gone wrong. In the first few weeks you may notice puffiness around the hip and thigh, and sometimes lower down toward the knee, ankle, and foot. It can look alarming, especially first thing in the morning or at the end of a busy day, but for most people it settles steadily over time. This guide explains why it happens, how to tell ordinary swelling from the kind that needs checking, and the simple things that genuinely help.

Why your hip and leg swell

A hip replacement is major surgery. To reach and replace the joint, the surgeon works through muscle and soft tissue, and your body responds the way it would to any injury, by sending fluid and blood cells to the area to begin repair. That fluid causes the swelling, or edema, that you see and feel.

There are a few reasons the swelling can spread down the leg. Gravity naturally pulls fluid toward your foot and ankle when you are sitting or standing, so it often pools lower down by the evening. Being less active than usual also matters, because the gentle pumping action of your calf muscles, which normally helps push fluid back up the leg, is reduced while you are resting and recovering. None of this means anything is wrong. It simply means your circulation is working a little harder than usual for a while.

Most people find swelling is at its worst in the first two to three weeks, then gradually improves. It is common for some mild puffiness to linger for several weeks or even a few months, particularly after a long day on your feet. You can read more about how this fits into the wider picture in our hip replacement recovery timeline.

What is normal and what is not

Normal swelling tends to be fairly even, builds up through the day, and eases overnight or when you rest with the leg raised. The skin may feel tight and warm, and the area can look bruised, with colors that change from purple to green and yellow as the bruising fades. Mild discomfort that responds to your usual pain relief is also to be expected.

What you are watching for is anything that feels different from this general pattern. Swelling that suddenly gets much worse, swelling that affects only one part of the leg such as the calf, or swelling paired with increasing pain, redness, heat, or feeling unwell deserves attention. The section near the end of this guide sets out the specific warning signs in plain terms, so you know exactly when to pick up the phone.

Elevation: the simplest thing that works

Raising your leg is the single most effective way to reduce swelling, because it lets gravity drain fluid back toward the body instead of letting it pool in your foot and ankle. The aim is to get your foot higher than your hip, so the fluid can flow downhill in the right direction.

Lie back on a bed or sofa and support the whole leg, from thigh to ankle, on firm pillows or a foam wedge. Avoid propping up only your ankle, which leaves the knee bent and the leg dangling and does little to help. Try to do this for fifteen to twenty minutes several times a day, especially after walking or exercise, and in the evening when swelling is usually at its peak. A leg wedge holds the position far better than a stack of pillows that slides apart, and it can also make resting and sleeping more comfortable. Our guide on how to sleep after a hip replacement has more on resting positions that respect your hip precautions.

Cold therapy and ice

Cold therapy is a great partner to elevation. Applying something cold to the area narrows the blood vessels, which calms both swelling and pain, and it is especially welcome after your exercises or at the end of the day.

A wrap-around cold pack that molds around the hip is far more practical than loose ice cubes, and a gel pack that you keep in the freezer can simply be reapplied whenever you need it. Always wrap any ice pack in a thin cloth rather than placing it straight onto the skin, and limit each session to fifteen to twenty minutes to avoid an ice burn. If your wound is still healing or has a dressing, keep the cold pack clear of it unless your surgical team has told you otherwise. For people who want a more hands-off option, a cold therapy machine that combines ice and gentle compression can be worth considering, which we cover in our best recovery tech for hip replacement guide.

Compression stockings

You may be sent home wearing compression stockings, sometimes called anti-embolism or TED stockings. These apply gentle, even pressure that supports your circulation, helps push fluid back up the leg, and lowers the risk of blood clots forming while you are less active.

Wear them exactly as your team advises, which is often during the day and sometimes overnight too, for a set number of weeks. They should feel firm but never painful, and they should not dig in or leave deep marks. If they feel too tight, roll down, or cause numbness or tingling, take them off and check with your team rather than putting up with it. A spare pair is handy so you always have a clean one while the other is washed.

Keep gently moving

It feels tempting to stay still when your leg is swollen, but gentle movement is one of the best things you can do. Every time your ankle and calf muscles work, they squeeze the veins and pump fluid back up the leg, which is exactly what reduces swelling.

Simple ankle pumps, where you point your toes up and down and circle your feet, can be done while resting and make a real difference. Short, regular walks within the limits your physical therapist has set keep the circulation moving without overdoing it. The key is balance: alternate spells of gentle activity with spells of rest and elevation, rather than sitting still for hours or pushing on until the leg throbs. Our exercises after hip replacement guide explains the early movements that help most.

Warning signs to take seriously

Most swelling is harmless, but a few symptoms point to problems that need prompt attention. Contact your surgical team, primary care doctor, or seek urgent care if you notice any of the following.

Signs of infection, such as the wound becoming more red, hot, or swollen, leaking fluid or pus, a spreading redness around it, a high temperature, or feeling generally unwell or shivery.

Signs of a blood clot in the leg, known as a deep vein thrombosis or DVT. This often shows as pain, swelling, warmth, or tenderness in one calf, sometimes with redness or a heavy, aching feeling. Swelling that is clearly worse in one leg than the other, especially with calf pain, should always be checked.

Signs of a clot that has traveled to the lung, called a pulmonary embolism or PE, which is a medical emergency. These include sudden breathlessness, sharp chest pain that is worse when you breathe in, coughing up blood, or feeling faint. If you have any of these, call the emergency services straight away.

You will not be wasting anyone’s time by checking. Surgical teams would far rather hear from you early than have you wait and worry, so if something feels wrong, make the call.

This guide is part of our hip replacement recovery series.