More than 193,000 total hip replacement surgeries are performed each year in the U.S., according to 2009 information from the American Academy of Orthopaedic Surgeons. During this surgery, diseased and damaged parts of the hip joint are removed and replaced with artificial parts, called the prosthesis. Osteoarthritis that produces pain and decreased mobility is the major cause of this surgery. While hip replacement surgery can have benefits, the possibility for complications exists.
Blood Clots
Surgery involving the lower extremities increases the risk of developing blood clots, according to the American Academy of Orthopedic Surgeons. One of the major risks of a hip replacement is deep vein thrombosis, or DVT, a blood clot that forms deep in a leg vein. The blood clot can break off from the vein and travel to the lungs, causing a pulmonary embolism. This very serious complication can cause death within hours. If the blood clot stays in the leg, chronic pain, swelling and damage to the vessel can result. Common preventive measures include blood-thinning medications, resuming some activity the day after surgery and elastic compression stockings.
Infection
According to a September 2009 article in "International Journal of Medical Sciences" by Konstantinos Anagnostakos and colleagues, infections following hip replacement surgery are one of the most serious complications. Infections can be superficial or deep. Superficial infections involve the surgical wound and surrounding tissue, and can be easily treated. Deep infections that involve the artificial hip are harder to treat. The emergence of bacteria that are resistant to many antibiotics compounds the problem. Treatment depends on the severity of the infection, and can include intravenous antibiotics, partial or complete removal of artificial parts, and placement of antibiotic-loaded beads into the hip.
Revisions
Revision surgery, or surgery to replace the artificial joint, may be necessary. After 15 to 20 years, the artificial joint can wear out. Revision is more difficult than the first hip replacement surgery and the outcome is usually not as good, according to the American Academy of Orthopedic Surgeons. Revision surgery is considered when joint loosening, infection, dislocation, bone loss and wear of the artificial joint surfaces occur.
Dislocation
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, or NIAMS, dislocation of the artificial hip is the most common complication soon after surgery. Certain positions can cause the ball to slip out of the socket. While hospitalized, physical therapists teach patients proper techniques for moving that prevent dislocation of the artificial hip.
Inflammation From Particles
Some hip replacement and resurfacing components consist of metal-on-metal parts that may produce small metallic particles during normal wear and tear, according to an article in the March 3, 2010 issue of "The New York Times". These particles can cause serious inflammatory reactions in surrounding tissue that can severely damage muscles, tendons and other soft tissue, and cause abnormal masses in the hip joint. The American Academy of Orthopedic Surgeons explains that inflammation from metallic particles may eat away some of the bone and cause the implant to loosen. Treatment may include anti-inflammatory medications or replacement of the artificial joint.
References
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Hip Replacement
- NYTimes: Getting a New Knee or Hip? Do It Right the First Time
- PubMed Central: Late Dislocation after Total Hip Arthroplasty
- American Academy of Orthopedic Surgery: Deep Vein Thrombosis
- NYTimes.com: As Use of Metal-on-Metal Hip Implants Grows, Studies Raise Concerns
