Red Flags After Surgery — When to Act Fast
Part of The Joint Replacement Guide — Phase 5: Recovery and Rehabilitation · Article 33 of 42 · Hip & Knee
Key Points
- Most recoveries are straightforward, but knowing the warning signs of the less common complications matters.
- Signs of infection, blood clot, dislocation, and fracture each have recognisable features worth knowing in advance.
- When in doubt, contact your surgical team or NHS 111 rather than waiting to see if symptoms improve on their own.
- Some symptoms warrant emergency care (999 or your nearest A&E) rather than a routine call.
Signs of Infection
Contact your team if you notice increasing redness, warmth, or swelling around the wound (rather than gradual improvement), new or worsening discharge from the wound, increasing pain after an initial period of improvement, or a fever. These can indicate a wound or, less commonly, a deeper joint infection, and are best assessed promptly rather than waited out.
Signs of a Blood Clot (DVT or PE)
A deep vein thrombosis (DVT) typically causes swelling, warmth, redness and pain in the calf or thigh, usually on one side more than the other, beyond what would be expected simply from the surgery itself. A pulmonary embolism (PE) — a clot that has travelled to the lungs — is more serious and can cause sudden breathlessness, chest pain (particularly when breathing in), a rapid heart rate, or coughing up blood. Suspected DVT symptoms should be assessed promptly; suspected PE symptoms — particularly sudden breathlessness or chest pain — are a medical emergency and warrant calling 999 or attending A&E immediately.
Signs of Dislocation (Hip Replacement)
A dislocated hip typically causes sudden, severe pain, often with an obvious change in the position or shape of the leg, and inability to bear weight or move the leg normally. This needs urgent assessment, usually at your nearest emergency department, so the joint can be safely put back into place.
Signs of a Fracture
Sudden, severe pain following a fall or significant knock, particularly with new inability to weight-bear or an obvious deformity, may indicate a fracture around your implant and needs urgent assessment.
Other Concerning Symptoms
Significant, worsening pain that isn’t controlled by your prescribed pain relief; new numbness, weakness, or loss of sensation in the leg or foot; or a general feeling of being unwell alongside your other symptoms, are all worth contacting your team about, even if they don’t fit neatly into the categories above.
Who to Contact
For non-emergency concerns, contact your surgical ward or the contact number you were given at discharge, your GP, or NHS 111. For the emergency features described above — particularly sudden breathlessness or chest pain, obvious dislocation or deformity, or inability to weight-bear after a fall — call 999 or go directly to your nearest A&E department.
In More Depth
It’s worth remembering that the great majority of patients never experience any of these complications — this article exists so that if something unusual does happen, you recognise it quickly and get appropriate help promptly, rather than because these events are common. Acting early on genuine red flags generally leads to better outcomes than waiting to see if things settle, and your team would always rather you contact them with a concern that turns out to be nothing than delay reporting something that needed prompt attention.
This article is general information and does not replace individual clinical advice. If you are experiencing any of the emergency features described above, seek urgent medical attention immediately.
Sources
- NHS.uk — recovering from hip and knee replacement, warning signs
- NICE guideline NG89 — venous thromboembolism, signs and symptoms
- British Orthopaedic Association — post-operative complication guidance
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