Managing Swelling and Scars After Surgery

After surgery, a swollen, puffy joint and a tight, raised scar are completely normal. Both are signs of healing. But if they're not managed, they can slow your recovery and limit how well you move.

Why swelling happens

Swelling is part of the body's healing response. Fluid and cells rush to the area to repair tissue. After joint surgery, swelling often peaks in the first few days and can come and go for weeks or even months, especially after knee surgery.

Too much swelling causes pain, stiffness and switches off nearby muscles, which is why managing it matters.

Managing swelling

• Elevate: raise the limb above heart level when resting, for example with pillows under the whole leg (not just under the knee)
• Cold therapy: ice packs wrapped in a cloth for 15 to 20 minutes, several times a day. Never put ice directly on the skin or wound.
• Compression: stockings or bandages if advised by your surgeon
• Movement: ankle pumps and gentle exercises act like a pump to move fluid out of the limb
• Pace yourself: short regular walks are better than one long one. Swelling rising sharply after activity is a sign to reduce slightly.

Caring for your scar

Before the wound has healed: Follow your surgical team's instructions exactly. Keep it clean and dry, and don't apply creams.

Once fully healed (stitches or clips removed, no scabs or discharge, usually after 2 to 3 weeks; check with your team):

1. Scar massage: using a plain, unscented moisturiser, press firmly with your fingertips and move in small circles, then along and across the scar. 5 to 10 minutes, once or twice a day.
2. Movement: gentle stretches that move the skin around the scar help prevent it from sticking to deeper tissues.
3. Sun protection: new scars burn easily and can darken. Cover them or use sunscreen for at least a year.
4. Silicone sheets or gels may help flatten raised scars. Ask your physiotherapist or doctor.

What's normal

• Numbness around the scar, which often improves over months
• Itching as the scar heals
• Redness that slowly fades over 12 to 18 months

Call your surgical team if you notice:

• Increasing redness, heat or spreading redness around the wound
• Pus or smelly discharge
• The wound opening
• Fever or feeling unwell
• Sudden, severe swelling of the calf with pain (possible blood clot)