Hip replacement surgery can be a godsend for those who suffer from chronic, end-stage arthritis. Removal of arthritic joint surfaces and replacing them with artificial components can mean a significant improvement in quality of life. For all the benefits that hip-replacement surgery provides, this procedure does not come without potential risks and complications.
Infection
One of the most devastating complications of hip replacement surgery is infection, even though the American Association of Orthopedic Surgeons describes an infection rate of less than 2 percent. Infection can occur soon after surgery as a post-operative complication, but late-onset infections can occur months or even years after the surgery.
Many factors, such as a weakened immune system or autoimmune diseases, can make a hip-replacement patient more vulnerable to infection. These infections can be caused by a process known as seeding, where bacteria in the bloodstream is transported to the site of the hip replacement.
The microorganisms settle in the hip area, where there is little defense because the artificial hip components lack blood supply. Antibiotics cannot work adequately, therefore, because they cannot reach the metallic and plastic components.
Blood Clots
Another potential complication of hip-replacement surgery is the formation of blood clots in the legs. The term commonly used for this condition is deep-vein thrombosis (DVT). The greatest risk with a DVT is that part or all of the clot can break away and travel to the patient's heart or lungs. A clot in the lungs, called a pulmonary embolism (PE), is a serious complication that, according to the journal "Circulation," published by the American Heart Association, is often fatal.
Loosening of the Components
Another complication of hip replacement is loosening of the components. According to the National institute of Arthritis and Musculo-Skeletal Diseases, loosening is one of the most common later complications of hip replacement.
Loosening can occur soon after the surgery, or months afterward. In cases where the components are cemented into place by special bone cement, loosening can occur in areas where the cement comes into contact with bone, or with the surfaces of the components.
Prosthetic components that are not cemented into place, and are intended to stimulate the patient's own bone to join to the components (a process called bio in-growth), can also loosen.
Dislocation
Unlike the normal biologic hips we are born with, stability of hip replacement components relies largely on precise positioning and alignment of all components, together with proper balancing and tension of the surrounding tissues. When there is instability, there is elevated risk of dislocation if you bend over too far or twist the wrong way, according to the Mayo Clinic's assessment of hip replacement risks.
Leg Length Discrepancy
Hip-replacement surgery requires surgeons to insert all components so that they can function properly, wear evenly and last a long time. Surgeons must ensure that, at the end of the procedure, the patient's legs are of equal length. As described in an article published by totaljoints.info, sometimes a patient will have a leg-length discrepancy, and this can be very bothersome. Patients might find it difficult to walk normally, and the discrepancy can cause increased stress to other body parts, such as the lumbar spine and knee joints.
References
- The American Association of Orthopedic Surgeons: Total Hip Replacement
- The Mayo Clinic: Hip Replacement Risks
- The National Institute of Arthritis and Musculo-Skeletal Diseases: Q&A about Hip Replacement
- The Orthopedic Research Institute of Australia: Hip Surgery Complications
- The American Association of Orthopedic Surgeons: The Value of Total Joint Registries
