4.5 post op as I was getting ready for bed I noticed my left ankle felt a little tender, "no unusual routine or additional walking" my calf ankle and foot are swollen about three times the normal size very unusual! Anyone have any suggestions of what this could be or if I should be worried?

Sorry not the best picture but the left side is huge doesn't look like it in the picture but it is

I had a similar issue and docs were concerned was a circulation issue - had a sonogram with no answers. A year later it appeared to be from tetracycline-induced fatty liver disease. The swelling and some other issues were resolved after stopping tetracycline.

Left foot.. is it warm to the touch?

I'd still see your doc just to rule out other potentials like a blood clot.

Please see your doctor it may simply be Medication but don't take any chances go to urgent care and make sure it is not a clot. Clots can kill especially if they start to travel to your heart.