Injury and degenerative diseases like osteoarthritis can cause progressive damage to the hip joint. Doctors often recommend total hip replacement surgery to help restore a patient's strength and range of motion in the affected hip. According to the American Academy of Orthopaedic Surgeons, the rate of serious medical complications from hip replacement surgery is less than 2 percent. The majority of complications that occur can be successfully treated or prevented.
Blood Clots
The development of blood clots in veins in the legs and pelvis is the most common complication of total hip replacement surgery, occurring in 10 to 20 percent of all cases, according to the Georgetown University Hospital. Significant and intractable leg swelling that develops after surgery may be an early sign of a blood clot; therefore patients who develop this symptom should be evaluated promptly by their physician. Blood thinning medications such as Coumadin and aspirin, ankle exercises to improve blood flow and supportive medical devices such as supportive leg hose may all help to prevent and treat blood clots, according to the American Academy of Orthopaedic Surgeons.
Dislocation
Hip dislocation occurs when the rounded head of the thighbone, or femur, pops out of the concave socket in the pelvis. According to MayoClinic.com, the femoral prosthesis is more likely to become dislodged in certain positions--especially if the patient bends his knee more than 90 degrees F or moves his leg laterally across the body. According to the Georgetown University Hospital, hip dislocation occurs in up to 5 percent of patients who have hip replacement surgery. Often, these dislocations occur during the first several weeks after surgery; however, dislocations can occur anytime, including 12 months or more after the operation. Additionally, about a quarter of all patients who have an early hip dislocation will suffer a second dislocation at a later time.
Prosthetic Loosening and Wear
Although the metal and plastic materials used to construct the hip prosthesis are durable, they are still susceptible to normal wear and tear over time. In addition, the components that hold the prosthesis together may loosen. According to Georgetown University Hospital, loosening often causes hip pain and requires follow-up surgery to fix the worn or loose parts.
Uneven Limb Length
During the course of hip replacement surgery, the surgeon works to tailor the prosthesis length and size to the individual patient; however, there is still a risk that the patient's legs will be uneven in length postoperatively. According to MayoClinic.com, in cases where this difference is caused by muscle weakness around the hip joint, physical therapy--including stretching and strengthening exercises--can help to resolve the problem. The American Academy of Orthopaedic Surgeons notes that other patients may need to make use of a shoe lift to even out the imbalance.
Osteolysis
Osteolysis is a condition in which cysts form in the bones at the hip joint, causing destruction and degeneration of bone tissue. According to the Georgetown University Hospital, osteolysis occurs as a response to plastic and metal particles released from the prostheses as they rub against each other when the hip moves. Nearby cells encapsulate this debris to try to prevent it from moving throughout the body; however, eventually the cells explode and the materials damage nearby bone tissue. Cysts then form in the damaged bone. Depending upon the type of hip replacement, osteolysis can occur in up to 10 percent of patients.
Infection
Contamination from surgical tools, migration of bacteria from the bowel or urinary tract into the hip during surgery or bacterial invasion of the wound post-operatively can all lead to infection. The rate of infection from hip replacement surgery is low; however, when infections do occur, they can be difficult to treat. According to the Georgetown University Hospital, infections occurring more than 2 to 4 weeks post-surgery often fail to respond to antibiotics and may require additional surgery to sterilize the hip and prostheses. A much higher percentage of infections developing within the first 1 to 2 weeks are treated successful with antibiotics without the need for further surgery.
