As with any major surgery, there are potential risks and complications you should be aware of before you undergo
total hip replacement surgery. A major cause of failure in
total hip replacement
is loosening of the prosthesis, either mechanical or by bacterial infection.
There is a very small chance of infection occurring (less than 1 out of 100 in first time hip replacements and less than 2 out of 100 for
revision hip replacements), but if infection occurs it is a very difficult problem to treat. If infection occurs, salvage of the prosthesis is successful dependent on several factors including:
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Type of bacteria.
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Patient health.
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Length of time from hip replacement surgery.
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How long the infection has been present. |
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In late or chronic infections, removal of the prosthesis is usually necessary. A spacer made of antibiotic loaded cement is placed and re-implantation of a new prosthesis is planned after several weeks of intravenous antibiotics. This “two stage” procedure is usually successful in eradicating the infection.
Great measures are taken to help reduce infections, which include:
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The use of sterile instruments, drapes, gowns and gloves.
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The patient’s leg is thoroughly cleaned with an antiseptic agent and all other areas are covered with sterile drapes.
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“Space Helmets” (body exhaust filtration systems) are worn by the surgical team, mainly during revision surgery.
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The patient is given prophylactic antibiotics prior to surgery and is generally continued for 2 days following surgery longer in cases of revision surgery.
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Because a bacterial infection from your mouth could infect your new joint, complete all dental work before surgery and always consult your physician before scheduling any post-operative dental work. |
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Mechanical loosening is when the implant loosens from their bony attachment, the motion between the bone and implant will cause pain, bone destruction and ultimately failure. The ideal candidate has approximately a 3% chance of loosening in a 10 to 15 year period. In non-ideal candidates such as patients who are younger, more active or excessively over weight, chances of loosening increase. Excessive wear can contribute to loosening and leading to revision surgery.
The most common problem that may happen soon after hip replacement surgery is hip dislocation. Because the artificial ball and socket are smaller than the normal ones, the ball can become dislodged from the socket if the hip is placed in certain positions. The most dangerous position usually is pulling the knees up to your chest.
Other complications include the formation of blood clots in the leg or pelvis. Blood clots cause chronic swelling in the affected leg and can travel to the lungs causing a
pulmonary embolism, a potentially life threatening problem. Be assured your doctor will take all necessary precautions to avoid blood clots that include:
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The use of blood thinning medications.
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Elastic stockings.
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The use of plastic boots that inflate with air to compress the muscles in your leg.
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Early mobilization beginning on the first day after surgery. |
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Other risks include strain on the heart and lungs resulting in heart attack, stroke or death; anesthetic risks, and possible damage to nerves, arteries and veins that can affect the circulation and function of the leg.
Overall, the risks are usually quite low and the chance of success greatly outweighs the chance of failure. If you have any concerns, always be sure to speak with your doctor.
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