About 200,000 hip replacements are performed in the United States each year. Over 90% are successful without complications of hip replacement during or after surgery. But, as with all operations, the risk of complications is always possible. However, complications occur infrequently and often reversible.
The older the person, the higher the risk of complications. A person over 80 years old has a 20% chance of developing at least one complication after a hip replacement surgery.
Complicated complications after surgery
Nerve damage
The serial nerve is under threat of accidental surgery because of its close proximity to the hip joint capsule. The same nerve may also become excessively stretched during the manipulation of the hip joint during surgery.
Depending on the degree of damage to the nerve, temporary or permanent damage may occur. There may be loss of muscle strength and feeling in parts of the leg. It may take up to 6 months or more. Most patients have numbness around the incision site, which may be permanent.
Vascular damage
The damage is associated with a direct injury to the blood vessels in the area of operation. A damaged blood vessel can be repaired by a vascular surgeon, if it falls on time.
Hip fracture
Force is applied during the surgical procedure. This can lead to a fracture of the femoral neck, especially in older patients or osteoporosis. Again, the problem is solved during surgery, but may lead to extended rehabilitation. The surgeon can place weight restrictions when walking.
Leg length mismatch
In some cases it is difficult to get exactly the same length of the legs. The result is usually a longer leg on the surgical thigh. This can be inevitable and deliberate in order to improve muscle function or stabilize the thigh. If the difference in diameter is greater than a quarter of an inch, a shoe lift may be required.
In some patients, both legs are the same length, but they think their legs are “longer”. In most cases, this “feeling” goes away when the patient adapts to his new hip.
Rarely, leg contraction occurs If the leg is significantly reduced after the operation, it can be dislocated.
Anesthetic complications
Complications can occur, and in rare cases even death. Your anesthesiologist will explain the risks associated with your surgery.
Complicated complications after surgery
Blood clots (deep vein thrombosis DVT)
This is one of the most common complications after a hip replacement. The most common area is in the calf. Increased pain in the legs is usually the most obvious symptom. Redness may also occur around the clots area. This is a small problem if the clots remain in the leg. But if they come out, they can reach the lungs (pulmonary embolism) and can lead to death (very rarely).
If your surgeon suspects blood clots, he will immediately order an ultrasound to confirm or rule out clots. Most surgeons order bed rest until the test results return to positive or negative for blood clots. He will prescribe blood thinner. Compressing boots and ankle / leg exercises help reduce the likelihood of blood clots.
Infection
Infection may occur during surgery or develop afterwards. This is one of the most serious risks for joint replacement. If the infection is located deep in the joints and surrounding tissues, it is often necessary to remove the new joint until the infection is cleared of treatment. If a patient develops an infection elsewhere in the body (bladder, teeth, chest), it must be controlled to prevent it from spreading through the blood to the new joint.
If you have rheumatoid arthritis or diabetes, or you take cortisone for a long time, you are more susceptible to infection within a few weeks after surgery.
Infection can occur many years after surgery. Bacteria can pass through the blood because of an infection in other parts of your body (bladder infection, infected wound, kidney infection). Oral antibiotics may be required before and after routine dental work after a hip replacement surgery.
Hip extension
The first six weeks after hip replacement are the most vulnerable times for your new hip. During this period, muscle tension is the only thing that keeps the metal ball in the socket. If the metal ball slips out of the socket, it will be dislodged. When the muscles of the hip joint regain their strength, and scar tissue forms around the ball, the risk of hip dislocation decreases.
Traditional hip replacement requires certain precautions to be taken, and some positions / movements are limited for at least the first 6 weeks. Your surgeon and physiotherapist will instruct you about your interfering hips. Basically, precautions:
- don't turn your fingers inside
- do not cross your legs
- do not bend the hip more than 60-90 degrees (when you sit, your knee should not be flat with the hips, it should be lower)
If dislocation occurs, call an ambulance to take you to the hospital. Your surgeon will pull the hip joint into place. If this happens often, a hip brace that is worn for several months will prevent further dislocations. Hip replacement using the anterior approach eliminates the need for thigh precautions or position / movement restrictions.
Those people who are overweight or have weak muscles are more prone to dislocation. Avoid heavy exercises that put too much effort on your new thigh (running, playing basketball, tennis, weightlifting). Instead, participate in activities such as walking, swimming, exercise bike.
Embarrassing problems
Your great spit, most of the knee of your femur, is below and outside the ball of your hip joint. Many of your big thigh muscles are fixed on the skewer, so it is necessary for the normal function of the thigh.
During lateral intervention, the trochanter is detached to access the hip joint. Then it is connected again. If the skewer does not heal on the femur, it remains separate. This can lead to pain, weakness and loss of hip function.
Intestinal complications
Constipation often occurs within the first week or so after surgery. This can be caused by medication, immobility, loss of appetite, and not drinking enough liquid. You may need a stool or enema softener.
Urinary problems
A catheter may be inserted during surgery. Your doctor will order removal as soon as it becomes practical, since catheters present an increased risk of urinary tract infection.
Hematoma formation
During surgery, the main areas of bleeding are controlled by cauterization. But some leakages of blood and fluids still occur, so the plums attach from the wound to the outside of the body. If the drain does not work as planned, a collection of blood and fluids forms in the area of the hip joint. This can cause pain, pressure and possible infection. Your surgeon can bring you back to surgery to drain the hematoma.
Weakening of the prosthesis
The harder your bones, the longer your thighs will last. Hard bones create a stronger bond. People with rheumatoid arthritis and osteoporosis are more at risk.
Running and heavy effects can also weaken the connection of the implant. Hold your weight, as this will increase the load on the hip joint. Every pound you get adds three pounds of strength to your thigh.
Choose a surgeon who has performed many hip replacements. Talk to some of his previous patients to find out how they do after hip replacement. Not all surgeons are the same. I saw several changes in the hip joint that were necessary only because the initial hip joint replacement was poorly performed by the original surgeon.
Herpes ulcers
In the coming days, after replacing the hip joint, you can spend quite a bit of time on the bed. Holding a long period of time in one position can lead to ulcers. Your heels, especially on your surgical pedicle, are very sensitive. A pillow or towel under your calves will swim along the heels and relieve pressure. The elderly are especially prone to pressure ulcers because their skin is softer and they also do not move. The close eye should be kept on the heels and in the area of the tail, and it should be regularly moved in bed with pillows.
Difficulties of blood transfusion
All blood intended for use in transfusions is screened for hepatitis B virus, hepatitis C virus, syphilis, human T-cell leukemia virus and AIDS virus But infections still occur. Hemolytic transfusion The reaction is due to incompatibility with the blood type of the donors. The most common cause of the hemolytic transfusion reaction is a clerical error (an incorrectly labeled sample or an incorrect definition of a patient receiving blood).
If you plan to use your blood for possible blood transfusions, tell your doctor in advance so that you can arrange surgery. Your blood can only be stored for 35 days. Harvesting should begin at least 10–14 days before surgery. The final collection takes place no later than 5 business days before the date of the transaction. Your blood will also be screened.
About thigh revision surgery
Most people who undergo a hip replacement surgery will never want to replace an artificial joint. But due to the fact that more and more people have a hip replacement at a young age, wear and tear on the surface of the joint can create problems. After 15–20 years of wear, replacement (revision surgery) of an artificial joint is becoming more common. A revision operation does not have as good result as the initial operation.
Review all complications of hip replacement before making a decision about surgery. This is not a complete list of risks, as there may be some rare complications not mentioned here.
