Joint replacement safety
Warning Signs After Joint Replacement: Call the Surgeon or 911?
Pain, swelling, warmth, bruising, and stiffness can occur after hip or knee replacement. The key is knowing which changes can be watched, which belong with the surgical team, and which need emergency care now.
- Call 911
- Sudden breathing trouble, chest pain, coughing blood, fainting, or another apparent emergency.
- Call the surgeon
- New calf changes, wound drainage, spreading redness, rapidly worse pain, or a major loss of function.
- Use the trend
- Stable or gradually improving soreness, swelling, warmth, bruising, and stiffness may fit the recovery plan.
- Use PT after clearance
- Physical therapy helps rebuild motion, walking, strength, and confidence after urgent medical concerns are addressed.
My shortest answer
Do not use a therapy visit to “test” a possible emergency.
Call 911 now for sudden shortness of breath, new chest pain, coughing up blood, lightheadedness, or fainting—symptoms that can occur with pulmonary embolism and need immediate medical help.1, 2
Contact the surgeon or on-call surgical team promptly for new or increasing calf pain, tenderness, redness, or swelling; worsening wound redness, swelling, drainage, or opening; or pain and function that rapidly deteriorate.2, 3
Your surgeon’s discharge instructions and after-hours plan take priority over this page.
Emergency symptoms
Call 911 for signs that may involve the lungs or circulation.
A pulmonary embolism can occur without obvious leg symptoms. Do not wait for the surgeon’s office to reopen, a return call, or the next physical therapy appointment.
Sudden trouble breathing
New or rapidly worse shortness of breath needs immediate medical attention.
New chest pain or discomfort
This is especially concerning when it worsens with a deep breath or coughing.
Coughing blood, lightheadedness, or fainting
Call 911. Do not drive yourself or try to walk the symptom off.
These symptoms do not prove that a pulmonary embolism is present. They mean the possibility requires emergency assessment.1, 2
Contact the surgical team
Report a possible clot, wound problem, or sharp setback promptly.
Symptoms alone cannot confirm a clot or infection. The right next step is medical guidance—not a harder exercise session or internet self-test.
Expected versus concerning
The direction of change matters more than a perfect recovery day.
Surgical soreness, warmth, swelling, bruising, stiffness, fatigue, and day-to-day variation can occur during recovery. No list can label a symptom “normal” for every person, operation, and stage.
Track and follow the written plan
- Symptoms are stable or gradually improving overall.
- A temporary increase has a clear activity trigger and settles as the care team said it should.
- The incision matches the written wound instructions.
- Walking and daily function are not rapidly deteriorating.
- No emergency, calf, or worsening wound signs are present.
Call when the pattern changes
- A symptom is new, severe, rapidly worse, or returns after meaningful improvement.
- Several warning signs appear together.
- Swelling, pain, or wound appearance no longer follows the surgeon’s plan.
- You suddenly need much more help or cannot perform a previously safe task.
- You are unsure whether a change fits the discharge instructions.
When the page and the surgeon’s instructions differ, follow the surgeon’s instructions.
Make the call useful
Give the team the details they should not have to guess.
Gather what you can without delaying urgent care. A short, specific report helps the on-call clinician understand what changed.
A simple call script: “I had a right/left hip or knee replacement on [date]. At [time], I developed [symptom]. It is [improving/stable/worsening]. I also have [wound, calf, breathing, or walking details]. What should I do now, and where should I be evaluated?”
Physical therapy’s role
Rehabilitation begins after the medical lane is clear.
A physical therapist can recognize a concerning pattern and help you reach the right team. Physical therapy does not replace the testing needed to evaluate a clot, infection, fracture, dislocation, wound problem, or medication complication.
What PT can assess
Walking safety, device use, range of motion, swelling trends, strength, balance, exercise response, and the daily tasks that still limit recovery.
What needs medical evaluation
Possible blood clot or pulmonary embolism, surgical-site or joint infection, wound drainage or opening, implant concern, fracture, or medication decision.
When the visit may stop
If a warning sign appears during therapy, the correct response may be to stop, contact the surgeon, or direct you to emergency care.
When progression resumes
After medical concerns are addressed and the care team’s restrictions are clear, rehabilitation can rebuild motion, strength, walking, endurance, and confidence.
Frequently asked questions
Practical answers after hip or knee replacement
1. Is swelling normal after joint replacement?
Swelling can occur after surgery, but the amount and duration vary. New or increasing calf, ankle, foot, or leg swelling—especially with pain, tenderness, or redness—belongs with the surgical team promptly. Breathing or chest symptoms require emergency care.1, 2
2. Is warmth or redness around the joint normal?
Some warmth and limited healing redness may occur. Increasing or spreading redness, tenderness, swelling, drainage, wound opening, or worsening pain should be reported. Use the wound instructions supplied by the surgeon.2, 3
3. What temperature is too high?
Use the threshold in your surgeon’s discharge instructions because programs and circumstances differ. Call sooner when fever occurs with chills, drainage, increasing redness or swelling, worsening pain, or feeling acutely ill. Do not dismiss a worsening wound simply because there is no fever.
4. Could calf pain simply be exercise soreness?
It could be muscular, but symptoms alone cannot reliably distinguish soreness from deep vein thrombosis. New or increasing calf pain, tenderness, redness, or swelling deserves prompt guidance from the surgical team.2, 4
5. What should I do if the incision begins draining?
Follow the dressing plan, note the amount and appearance, and call the surgical team. New, increasing, persistent, or concerning drainage—or an opening in the incision—should not wait for a routine therapy appointment.2, 3
6. What should I do after a fall?
Stop and avoid forcing the joint. Contact the surgeon for new pain, swelling, loss of motion, or difficulty bearing weight. Call 911 for an apparent emergency, a serious injury, or when you cannot move safely.
7. Can a physical therapist rule out a clot or infection?
No. A therapist can identify a concerning pattern and direct you to the appropriate team, but diagnosis may require medical examination, imaging, ultrasound, laboratory testing, or other workup.
8. What if the surgeon’s office is closed?
Use the surgeon’s after-hours or on-call number. Call 911 for emergency symptoms. If the change is rapidly worsening or the on-call team directs you to do so, seek emergency-department evaluation. Do not wait for the next physical therapy visit.
Clinical sources
Official guidance used for this page
- CDC: About Venous Thromboembolism (Blood Clots) — reviewed for DVT and pulmonary-embolism symptoms and urgency.
- American Academy of Orthopaedic Surgeons: Total Knee Replacement — reviewed for postoperative clot and infection warning signs.
- American Academy of Orthopaedic Surgeons: Infection After Joint Replacement — reviewed for the range and timing of possible joint-infection symptoms.
- American Academy of Orthopaedic Surgeons: Deep Vein Thrombosis — reviewed for DVT context after lower-extremity surgery.
Medical disclaimer: This page provides general education, not diagnosis or individualized medical advice. It does not replace your surgeon’s written discharge instructions, medication plan, wound guidance, after-hours directions, or emergency services. If you believe you are experiencing a medical emergency, call 911.
After medical concerns are cleared
Need a measured plan for the recovery work that comes next?
Argan provides one-on-one mobile outpatient physical therapy for medically stable adults in Southlake, Colleyville, and selected nearby DFW addresses. We can assess motion, walking, strength, balance, device use, and the daily task you want back.