Thigh swelling after total hip arthroplasty: time course and prevention by an adjustable compression supporter

Purpose Post-operative thigh swelling is a common concern following total hip arthroplasty (THA), potentially impeding early recovery, especially after the direct anterior approach (DAA). This study aimed to quantify the time course of thigh swelling after DAA THA and to evaluate the efficacy of a specialized compression supporter in mitigating it. Methods This single-center retrospective comparative study involved 141 patients who underwent primary unilateral DAA THA. An intervention group ( n = 77) wore a proximal thigh compression supporter for 5 days post-operatively, while a control group ( n = 64) received no compression. The primary outcome was change in thigh circumference. Secondary outcomes included patient-reported pain and swelling, hip range of motion, and functional scores, measured pre-operatively and at post-operative day 1 (POD1), POD5, 2 weeks, and 12 weeks. Results All patients in the intervention group completed the 5 day wear protocol without any dropouts. In the control group, thigh circumference peaked at POD5, increasing to 106.9 ± 4.1% of the pre-operative baseline before returning to baseline by 12 weeks. The supporter group had a significantly suppressed trajectory of swelling over time compared with the control group (interaction p < 0.001), with significantly less swelling at both POD1 and POD5. At POD5, the intervention group also reported lower pain scores (median numeric rating scale 4.0 vs. 5.0; p < 0.01) and less subjective swelling ( p = 0.01). Furthermore, they achieved superior hip flexion at 2 weeks (104° vs. 100°; p < 0.01). By 12 weeks, clinical outcomes were comparable between groups. No compression-related complications occurred. Conclusion A targeted proximal thigh compression supporter effectively reduces early post-operative swelling and patient distress after DAA THA during the first 5 days. This simple, non-invasive intervention may enhance the quality of the patient’s early recovery experience. These findings warrant confirmation through future prospective, randomized trials.