After surgery, sitting causes blood to sit in your leg veins, with a risk of clotting, it’s better to have your legs up!

The risk of swelling in the legs going on to leg clots can be reduced by using the calf muscle to pump the blood back to the heart, we advocate getting up for a brief walk every hour. The next best thing is to have your legs up, by which we mean – almost as high as your heart – such as on a bed, or laying across a window seat. Some lounges are too soft to easily get out of, some are too low for hip replacements, although the hip replacements done through an anterior approach seem to have a lower risk.

Some patients have a recliner – but it’s hard to have an absolute rule on these… Recliners that are soft and low might need you to lurch to get out of them, putting hip replacements inserted through the buttock approach at risk of dislocating. Some recliners need you to forcibly flex your knees to close down the leg rest, and that might be hard after knee replacement. Lurching towards your hip replacement side to activate the handle to put the foot rest up or down is a risk. But some patients have electrically adjustable recliners that even help them get out of the chair, and these are fine.

Sitting in a chair, with your leg up on a footstool does not work. Perhaps the veins in the groin are squeezed, perhaps the foot just isn’t up high enough?

Other things we do to minimise clots are wearing firm compression stockings (like used for international’s airflights) during the day time, and not to sit for more than 5-10 minutes at a time. If needing to be driven a distance to get home, we say get out of the car briefly and walk around at least every hour. There is no medication that guarantees clots won’t occur, we tend to use aspirin, but for higher risk patients use more powerful blood thinners.

Cheers

David Mitchell
Orthopaedic Surgeon