Why does your foot swell after knee surgery? (+1 factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss why your feet swell after knee surgery. We will also discuss other factors which may cause swelling of the foot after knee surgery. Some useful tips are also included to reduce the degree of swelling after knee surgery.
Why does your foot swell after knee surgery?
Your foot may swell after a knee surgery due to the accumulation of fluid, known as oedema. This occurs due to the manipulation of the knee joint during surgery which often causes trauma to the adjoining tissues.
Trauma may lead to the drainage of fluid in the lower limbs, including the feet. Foot swelling after knee surgery is a normal condition. You may experience moderate to severe swelling and pain during the first few weeks.
Foot swelling begins to decrease over the following weeks and months. Sometimes foot swelling can last up to six months of knee surgery, although it is considered normal. Consult your doctor if the problems persist for a longer time.
What does research suggest?
In one of the case reports, it was established that patients treated by an orthopaedic surgeon (n=61) who used drains and performed knee surgery in a shorter time had the lowest incidence of developing swelling in the feet (2).
In another study, it was established that if ankle surgeries are performed without a tourniquet, the incidence of swelling and pain in the foot is significantly reduced. The hospital stay length also becomes shorter (3).
In another case report, 116 patients had venous insufficiency in the lower extremity vein after knee surgery. The pre-operative great saphenous diameter (GSV) and GSV reflux duration (>1.23 seconds) were the best predictors of swelling after knee surgery (4).
What other factors may cause foot swelling after knee surgery?
Some other factors may cause foot swelling after knee surgery, including:
| Factor | Reason |
| Liver disease | Liver diseases, such as fatty liver and liver cirrhosis, can cause swelling of the feet in addition to abdominal bloating, yellowing of the skin, and fatigue. |
| Kidney dysfunction | Decreased kidney function causes retention of sodium in your body. This leads to swelling of the feet and ankles. |
| Pregnancy | Total blood volume usually increases during pregnancy to support the development and growth of the baby. This causes swelling of the lower limb and feet. |
| Sciatica | The myelin sheath around the sciatic nerve may be damaged if the pressure on the nerve continues for a long time. This may cause leakage of fluid around the compressed nerve, subsequently leading to foot swelling (5). |
| Obesity | Due to excessive pressure on the foot, the degree of foot swelling is more common in obese patients, especially after knee surgery (6). |
| Varicose veins | Twisting of varicose veins may cause swelling in feet and ankles. Varicose veins may also cause pain, aching, and discomfort. |
How to reduce foot swelling after knee surgery?
Although swelling after knee surgery is not a life-threatening condition itself and serves an important purpose in the immune system and inflammatory chain of the healing process, excessive swelling may cause deep vein thrombosis and the formation of clots.
Elevate your legs
You should elevate your legs above your heart level gently to reduce the degree of foot swelling. Elevation of the legs improves fluid circulation from the feet and legs to the rest of the body.
Diet
You should limit your intake of salt as it may increase fluid accumulation and oedema in the foot area. You should also increase your intake of water to help your foot and ankle mobility to reduce swelling at that site.
Eat fruits, leafy vegetables, berries and nuts. The extra water present in fruits and vegetables helps to flush out excess water from the body. They also help to improve your overall health after knee surgery.
Nuts, green vegetables, dark chocolate, and milk are good sources of magnesium. Magnesium helps to limit water retention. Your doctor may also prescribe magnesium supplements to help reduce swelling in your feet.
Use ice packs
You should use regular ice packs after knee surgery to reduce swelling and fluid accumulation. Applying an ice pack at the affected site, including the feet, constricts the blood vessels, reducing the flow of fluid in that area.
Medication
Some patients may be advised to take blood-thinning agents such as aspirin and enoxaparin to reduce the likelihood of blood clot formation after knee surgery. According to research, blood clots are one of the reasons for foot swelling after knee surgery (6).
Your doctor may also prescribe you painkillers and anti-inflammatory drugs, such as acetaminophen, ketamine, ibuprofen and meloxicam after knee surgery. You may take naproxen if you are allergic to ibuprofen.
It is not uncommon for patients to experience oedema, swelling, and pain after knee surgery. However, I would suggest you discuss your symptoms with an orthopaedic surgeon if foot swelling begins to affect your quality of life.
As a pharmacist, I often advise compression stockings for swollen feet. They are easily available at the pharmacy. You should avoid exercising or putting undue pressure on your knee and foot as it may increase swelling and pain.
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References
1.-
Christensen LM, Arnesen CE, Möller S, Hyldig N. The effect of compression therapy on post-surgical swelling and pain after total knee arthroplasty. International Journal of Orthopaedic and Trauma Nursing. 2021 Apr 1;41:100815. https://www.sciencedirect.com/science/article/abs/pii/S1878124120301210
2.-
Garrett BR, Walters J. Knee pain, swelling and stiffness after total knee replacement: a survey of South African knee surgeons. SA Orthopaedic Journal. 2010 Jan;9(2):59-66. http://www.scielo.org.za/scielo.php?pid=S1681-150X2010000200008&script=sci_arttext
3.-
Smith TO, Hing CB. The efficacy of the tourniquet in foot and ankle surgery? A systematic review and meta-analysis. Foot and ankle surgery. 2010 Mar 1;16(1):3-8. https://www.sciencedirect.com/science/article/abs/pii/S1268773109000368
4.-
Cansabuncu G, Gumus F. Pre-operative predictors of lower extremity swelling following total knee arthroplasty in patients with venous insufficiency and osteoarthritis. International Orthopaedics. 2021 Oct;45:2561-7. https://link.springer.com/article/10.1007/s00264-020-04888-0
5.-
Chu EC, Wong JT. Subsiding of Dependent Oedema Following Chiropractic Adjustment for Discogenic Sciatica. European Journal of Molecular & Clinical Medicine. 2018 Mar;5(1):1-4. https://d1wqtxts1xzle7.cloudfront.net/56355567/ejmcm-250-chu-libre.pdf?1524118393=&response-content-disposition=inline%3B+filename%3DSubsiding_of_Dependent_Oedema_Following.pdf&Expires=1703945206&Signature=XG5hv4dWa53m~n7uuPPvr2siuRLtRS6OjetiZ9jHS7cfMh5QriQ-uQZ-TAgtHdBoKSq5j1Fx4dIVTsprJCyHugkWX6DLYfJn46vPgSr-nROPDHvPJ0lXNXTaufjSJHdMq1VDEw6mPJGTlQXix4fKzKNSRRczaJhzUSCR-YaThQvQgOggKp0sZRzyR4ZGqUe9hSo6pfR9F9rAiWduBxE1SWBZbUwuySE9JFeaaUvcU3e0npqtmGWSQClj8JeSnXE955cfKkm~AH1flBQyUKQNzkOz~wbJR2xFhrKA~URzD–Gdb5OwFLdlkmKzyupojo-vmhJBTmXFL1qYw~ZnoehxA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
6.-
Gao FQ, Li ZJ, Zhang K, David H, Liu ZJ. Risk factors for lower limb swelling after primary total knee arthroplasty. Chinese medical journal. 2011 Dec 5;124(23):3896-9. https://pubmed.ncbi.nlm.nih.gov/22340316
