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How to look out for infection after your Hip or Knee Replacement

Important: Watch for Infection After Your Hip or Knee Replacement. After your surgery, your body is healing — but it’s important to know the signs of infection. Infections are rare but serious, and need quick treatment to protect your new joint.

When to contact us

Contact Chelsea and Westminster (via the ACP or the ward) immediately if you have:

  • Redness that is spreading or getting worse around your wound
  • Swelling that is increasing instead of settling down
  • New or increasing pain in your joint or wound site
  • Fluid or pus leaking from your wound, especially if thick, yellow or smelly
  • The wound feels hot or tender
  • The wound looks like it’s not healing or is opening up

Go to A&E if it is out of hours, or if you have:

  • A high temperature (fever) over 38°C (100.4°F)
  • Shivering, chills or sweating
  • You feel very unwell, confused, drowsy or faint
  • A fast heart rate or breathing quickly
  • Severe pain in or around the joint, worse than before

Why this is important: If an infection spreads to your joint, it can be very serious and may need further surgery. Early treatment can prevent this.

Do not remove or change your dressing yourself. Keep it clean and dry—avoid getting it wet in the shower or bath.

Do not touch or scratch the dressing. Your dressing will usually be changed or removed around two weeks after your operation. Please contact us if you do not receive this appointment, or sooner if the dressing becomes loose, dirty or soaked.

GPs or Nurses: Please don’t remove the dressing or swab the wound without speaking to the Orthopaedic team.

How to reduce your infection risk before and after surgery

Before surgery: What you can do

Wash your skin thoroughly

  • Use the Hibiscrub provided at your pre-op assessment appointment.
  • Wash your whole body every day for five days before surgery.
  • Do not shave your legs or hip area before your operation.

Stop smoking early

  • Smoking slows healing and increases infection risk.
  • Stop at least six weeks before surgery.

Eat and drink well

  • Good nutrition helps your body heal and reduces infection risk.
  • Tell us if you’ve lost weight recently or have a poor appetite.

Check your weight (BMI)

  • A higher Body Mass Index (BMI) increases infection risk.
  • If your BMI is over 40, your team may support you with weight management before surgery.

Manage your diabetes

  • If you have diabetes, keep your blood sugar under control.
  • We aim for HbA1c <61mmol/mol (7.7%) before surgery.

After surgery: Keep your wound safe

Don’t touch or remove your dressing

  • Your dressing protects your wound and should stay in place until your nurse changes it.
  • If you have a PICO dressing (with a pump), ensure the pump is working. Do not remove it.
    • PICO may stop working after 7 or 14 days depending on the type—check before discharge.
    • If it stops, leave it on and inform the team. Do not disconnect it.

Look out for warning signs

  • Redness or warmth around the wound
  • Discharge
  • Fever or chills
  • Increased pain or swelling

Know who to contact if you’re worried

  • Your surgical team – ACP, ward or fracture clinic (see contact details below)
  • Out of hours – attend the Emergency Department and tell them you’ve recently had surgery

Helpful reminders

Keep the area clean and dry. Do not bathe or soak the wound until advised. Follow your discharge instructions carefully.

GPs or Nurses: Please don’t remove the dressing or swab the wound without speaking to the Orthopaedic team.

Contacts

  • Advanced Clinical Practitioner (Amy): 07884 763560 (7:30am–5pm Mon, Tue, Thu, Fri)
  • David Evans: 020 3315 8521 (9am–5pm including weekends)