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Risks
By Mayo Clinic staffHip replacement surgery is generally safe, but as with any surgery, complications can occur. Although some complications are serious, most can be treated successfully. Complications of hip replacement include:
- Blood clots. Clots in your leg veins can form as a result of decreased movement of your leg after surgery, as well as from injury to the veins during surgery. Your doctor usually gives you blood-thinning medications after your surgery to try to prevent clots from forming. Compression devices, such as elastic stockings, and exercise to increase blood flow through the veins in your legs also can reduce your risk.
- Infection. Infections can occur at the site of your incision and in the deeper tissue near your new hip. Most infections are treated with antibiotics, but a major infection near your prosthesis may require surgery to remove and replace the prosthesis.
- Fracture. During surgery, healthy portions of your hip joint may fracture. Sometimes, the fractures are so small that they heal on their own, but larger fractures may be corrected during surgery with wires, cables or bone grafts.
- Dislocation. Certain positions can cause the ball of your new joint to become dislodged. To avoid this, it is often recommended that after surgery you don't bend more than 90 degrees at the hip and don't let your leg cross the midline of your body. If the hip dislocates, your doctor may fit you with a brace to keep the hip in the correct position. If your hip keeps dislocating, surgery is often required to stabilize it.
- Loosening. Over time your new joint may loosen, causing pain in your hip. Surgery might be needed to fix the problem.
- Breakage of the prosthesis. Though rare, your artificial hip can break several years after surgery. Another surgery would be required to replace the broken joint.
- Change in leg length. Your surgeon takes steps to avoid the problem, but occasionally your new hip may make your leg longer or shorter than the other one. Sometimes this is caused by weakness in the muscles surrounding your hip, also placing the hip at risk of dislocation. In this case, progressively strengthening and stretching those muscles can make it more stable.
- Joint stiffening. Sometimes the soft tissues around your joint harden (called ossification), making it difficult to move your hip. This usually isn't painful. If you're at risk of ossification, your doctor may recommend medications or radiation therapy to prevent it from happening.
- Wear and tear over time. Your prosthetic hip joint may wear out eventually, so if you have hip replacement surgery when you're relatively young and active, you may need a second hip replacement within your lifetime. However, new materials are making implants last longer, so a second replacement may not be needed for many years.
References
- Erens GA, et al. Total hip arthroplasty. http:www.uptodate.com/home/index.html. Accessed Feb. 16, 2009.
- Erens GA, et al. Complications of total hip arthroplasty. http:www.uptodate.com/home/index.html. Accessed Feb. 16, 2009.
- Questions and answers about hip replacement. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp. Accessed Feb. 16, 2009.
- Total hip replacement. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00377. Accessed Feb. 16, 2009.
- Huo MH, et al. What's new in hip arthroplasty. The Journal of Bone and Joint Surgery. 2008;90:2043.
- Lenssen AF, et al. Role of physiotherapy in peri-operative management in total knee and hip surgery. Injury. 2006;37(suppl):S41.
- Ferrara PE, et al. Effect of pre-operative physiotherapy in patients with end-stage osteoarthritis undergoing hip arthroplasty. Clinical Rehabilition. 2008;22:977.
- Vukomanovic A, et al. The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty. Vojnosanitetski Pregled. 2008;4:291.
- O'Donnell M, et al. Reduction of out-of-hospital symptomatic venous thromboembolism by extended thromboprophylaxis with low-molecular-weight heparin following elective hip arthroplasty. Archives of Internal Medicine. 2003;163:1362.
- Cawley Y. Mechanical thromboprophylaxis in the perioperative setting. Medsurg Nursing. 2008;17:177.
- Prokuski L. Prophylactic antibiotics in orthopaedic surgery. Journal of the American Academy of Orthopedic Surgery. 2008;16:283.
