Will hip replacement surgery make my lymphoedema worse?

[LymphSuppNetwork]

In the next in our series of questions to Professor Mortimer, he and Anita discuss the effects having a hip replacement might have on leg lymphoedema.

youtu.be/u83PwqF7z6g(Not working as expected?)

[MsDEL]

The short answer in my experience is - no negative impact on my Lymphodema in the long term, but it was very difficult to manage for 6 months convalescence and remained more swollen for 12 months. This was probably because of my particular complications though. My tale might give a worst case that could be planned for! I had a hip replacement 3 years ago on my left leg which is affected by Lymphodema. My Lymphodema is only in my left leg and followed treatment for uterine cancer. I had anastomosis surgery 7 years ago (at Oxford) and this has meant the management of my Lymphodema has been efficient and I have never had cellulitis. Prior to hip surgery I was wearing size1 compression garments for some of the day just to keep my leg stable. I had previous surgery to my hip (pre Lymphodema). Mr Furniss at Oxford provided a letter for me to inform my hip surgeon about Lymphodema. The plan had been to compress immediately following surgery to keep post op swelling to a minimum, but unfortunately complications meant no compression could be given for 4 days. Plus, immediate swelling meant that my size 1 garments didn't fit. My leg swelled to the largest it's ever been in my post op week, meaning new compression garments had to be sought and this eventually meant that I was without prescribed compression garments for 6 weeks. I was also no weight bearing for the same time, then light weight bearing for further 6 weeks. In hindsight I could have had a visit booked from my Lymphodema nurse to coincide with hospital discharge and some of the delays in management could have been delayed. Throughout my hip convalescence I maintained manual drainage (my partner did it so I didn't bend over my new hip) and used bandaging to replace compression garments. Once I had replacement (larger) garments and was allowed to walk my leg started to reduce in size. It returned to my pre-hip replacement size about 12months after surgery. Swelling around my knee is worse than pre hip replacement, but not debilitating. It was determined effort that got me to this place, but made so much easier by my hip replacement as I now enjoy many walks. The effort was worth it!

Advice I'd give - insist on compression garments in hospital if at all possible, a visit from a Lymphodema nurse whilst still in hospital or on immediate discharge to make sure garments are appropriate and available, maintain manual drainage with massage and movement, bandaging if appropriate, sleep with foot of mattress raised, walk as soon as hip surgeon recommends and as much as you can to aid healing of Lymphodema and (of course) your new hip.

Most important - enjoy your new, pain free hip!

[kHP22]

I had a knee replacement on a very large Lymphoedema leg two years ago and I was extremely worried about it but thankfully it all went well . My movement is definitely improved . It sometimes still feels a bit strange as though I have something alien in my knee but it’s certainly been worth risking it

[Bigangel in reply to kHP22]

I am so happy to read this as, if other circulatory problems can be overcome, I hope to have a knee replacement at some time this year. I am working on losing weight but my consultant says that it won't make a lot of difference to the size of my legs.

[kHP22 in reply to Bigangel]

I was worried that it might make my Lymphoedema worse but it didn’t . It’s still a risk though especially if there had been any sort of infection and it needs careful thought . My consultant did warn me that if it went wrong it could be catastrophic for me but I was at the point where my quality of life was very poor because if it . More and more surgeons though are carrying out this type of surgery on people with Lymphoedema so ask him if has any experience of it . I had extra antibiotic cover as I’d had cellulitis in the past in that leg . You will need to be prepared as well because it’s very difficult lifting your leg up and down to get up when you’ve got the added weight of the Lymphoedema and the stitches in so you will need someone with you 24/7 to help at the beginning and support the leg .