Total Hip Replacement
What are the complications and risks of having a total hip replacement?
The complication rate following hip replacement surgery is very low. However like all surgery, there are risks that need to be considered when deciding to have hip replacement surgery.
Side effects are symptoms that occur due to the surgery and are a normal part of the recovery from the operation. The main side effects of hip replacement surgery are:
- A sore hip which may last for several weeks after the operation
- Swelling in the thigh which will also last for several weeks after the operation
Complications are problems that occur during or after the operation. Most people having hip surgery aren't affected. There are some complications that may occur for any operation. These include:
- A reaction to the anaesthetic
- Infection of the wound or joint
- Excessive blood loss
- A blood clot, usually in a vein of the leg (known as a deep vein thrombosis or DVT)
Specific complications of hip replacement are uncommon, but can include the following:
- Joint dislocation: Dislocation of the hip joint is when the ball of the hip pops out of the socket. Dislocation occurs in 1.7 – 4.1% of people who have had hip replacement surgery. A dislocated hip may be relocated without surgery or may require a new hip replacement to fix the problem.
- Infection: The hip replacement can become infected. This is a rare but serious complication of hip joint replacements. The risk of this occurring is between 0.02 – 1.1% of all people having a joint replacement. Antibiotics are used after the operation to reduce the chance of an infection occuring.
- Difference in leg length: After the operation, the leg that has been operated on may be slightly longer than the other side. This occurs commonly, up to 62% of the time. Usually it doesn’t cause any problems but may lead to pain or dislocation of the hip in some cases.
- Fractures: A fracture is a break in the bone. Fractures can occur during a total hip replacement while the new hip is being put in place. This occurs in between 0.3 – 5.4% of total hip operations. Usually these fractures heal but sometimes require further surgery.
- Loose joint: The hip replacement may become ‘loose’. This is a rare complication that may require another operation to fix the problem.
- Nerve damage: Nerves can be damaged during the operation which can cause numbness or weakness in areas of the leg. This is a rare complication, occurring in roughly 0.17% of people undergoing hip replacements
It is important to note that the risks of certain complications may be higher or lower than the figures quoted if the person having the operation has a medical condition that makes them more vulnerable to risks. For instance we know that obesity significantly increases the risk of an infection after a hip replacement.
Hip revision surgery
During your original hip replacement, your hip joint was replaced with artificial hip parts. Hip revision surgery means having another operation to replace the worn out components of a hip replacement. Hip replacements usually last between 10 – 15 years.
Replacing an artificial hip joint is a more complex operation than the original hip replacement. It will often take longer and there are higher rates of complications than the original surgery.
The most common causes of infection following hip replacement surgery are from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your prosthesis.
Following your surgery, you may need to take antibiotics prior to having any dental work.
Warning signs of a possible hip replacement infection are:
- Persistent fever (higher than 37.5°C orally)
- Shaking chills
- Increasing redness, tenderness, or swelling of the hip wound
- Increasing hip pain with both activity and rest
Notify your doctor immediately if you develop any of these signs.