Complications of Hip Replacement Surgery - Eunice

Complications of Hip Replacement Surgery
- Deep vein thrombosis: most common complication. May develop into pulmonary embolism(s). Prevented by using compressive calf pumps, leg exercises or Coumadin (blood thinning drug).

- Infection: found to be higher in hip replacement surgery than any other types of surgery. Risk of infection is higher if patient has rheumatoid arthritis or diabetes, has been taking cortisone for prolonged periods of time, if the affected joint has been infected before, or if the patient has infection anywhere else in the body at the time of the infection.

- Loosening of the prosthesis from the bone: will happen over time, in a process called osteolysis. Revision surgery may be needed if this happens. How long the bond will last depends on:
a. How well the surgery is done
b. The quality of the patient’s bones: The harder the bones are, the better the bond will be, and the longer the replacement will last. Osteoporosis is a factor of age, as well as the type of arthritis you have. People with rheumatoid arthritis have especially soft bones.
c. How active the patient is: Excessive force on the implant can cause the bond to loosen. Activities such as running and heavy lifting should be avoided.
d. Weight: Every pound of weight the patient adds three pounds to the force and stress on the hip so he/she should try to maintain an ideal weight.
e. Whether or not the implant is cemented: At present it is believed that uncemented implants will last longer than cemented ones.
f. The design of the implant: Small abrasion particles from the implant may play a role in implant loosening. Plastic surfaces shed more particles than metal or ceramic ones.
g. People with osteoporosis and rheumatoid arthritis are also more at risk.

- Wear of the plastic polyethylene socket

- Dislocation of the hip replacement: where the metal ball slips out of the plastic socket. In the first six weeks after surgery, the ball is only held in place by muscle tension. During this time, before scar tissue forms around the ball and before muscle strength returns, the hip is more likely to dislocate.

- Extra bone formation (ectopic bone) around the artificial hip: causes the hip to be stiffer than desired. More likely to occur in younger males with severe osteoarthritis. Can be treated by surgical removal of the bone when it matures.

- Fracture of the femur: can occur during hip replacement, and can either be a small crack or deep fracture.

- Residual pain and stiffness: in the thigh, groin or knee, but usually transient. Chronic pain may remain in 2-5% patients.

- Change in the length of the leg: sometimes the surgeon will deliberately lengthen the affected leg to stabilise the hip or improve muscle function. In the first few weeks after surgery, most patients complain that the operated leg feels too long even when the legs are perfectly equal in length, which is an artificial sensation which will resolve itself after a few months.

- Injury to the arteries or nerves in the leg: may cause pins and needles, foot and leg nerve pain or weakness and numbness

- Excessive bleeding: can occur into the wound, forming haematomas. This may distend the hip and cause a dislocation. May require surgery to remove the haematoma if serious. Blood thinners may also cause bleeding into the urine, but this is usually temporary and not serious.

- Anaesthetic complications: include nausea and vomiting, cardiac problems (e.g. heart attack) and cerebral complications (e.g. stroke).

- Allergy to the metal parts

- Complications from blood transfusions

- Fat embolisms: fat from the bone marrow can get into the circulation, causing lung or neurological symptoms. Is very rare though.

- Trochanteric problems: the greater trochanter is detached during surgery to access the hip joint and is then reattached. If the trochanter does not heal back on the femur, it remains as a separate piece, and may result in pain, weakness and loss of hip function since many large muscles attach to the greater trochanter.

- Bowel complications: constipation frequently occurs for the first week or so after surgery, and can be caused by medication, immobility, loss of appetite, not drinking enough fluids.

- Urinary problems: a catheter may be inserted during surgery, which poses an increased risk of urinary tract infection.

- Pressure sores: patients will most probably be spending more time in bed in recovery. Spending a lot time in one position can lead to pressure sores. The heels, especially that of the surgery leg, are especially susceptible. The elderly are especially prone to pressure sores, so more attention should be paid to such patients.


http://www.hipsandknees.com/hip/hipsurgerycomplications.htm
http://ezinearticles.com/?Hip-Replacement-Complications&id=430604
http://orthopedics.about.com/od/replacementcomplications/Information_About_Joint_Replacement_Complications.htm