Hip Replacement Risks
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Hip replacement surgery is commonly performed. Overall, it is extremely safe. However, in a small number of patients, unwanted complications can occur. Below is a description of some of the complications that can occur.
Before and during hip surgery, we take a number of steps to limit infection. The University of Maryland is a leader in the prevention and treatment of joint replacement infection. Overall, infection associated with hip replacement is uncommon.
However, infections do occur, and when they occur, their treatment is disruptive for the patient and the surgeon. If an infection occurs around the hip replacement, the hip replacement parts usually have to be removed. After the parts are removed, a temporary antibiotic hip is placed for 3 months and then the hip surgery is redone (three total operations). Although infection infrequently occurs around a hip replacement, patients should be aware that it is an associated risk.
Hip replacements are not as stable as native hips, and dislocation where the head ball pops out of socket is a possible risk associated with hip replacement. At the University of Maryland, we use specific techniques to prevent dislocation and have achieved an extremely low dislocation rate. For most patients, we do not impose specific long-term limitations on hip movement. However, the hip replacement is always going to be slightly more prone to dislocation than the native hip joint.
Differences in Leg Length
Most patients with hip arthritis have one leg that is shorter than the other. The shorter leg usually is the one with the hip arthritis. During hip replacement, we use multiple techniques to equalize leg lengths to the extent possible. It is not possible to get them exactly laser-line equal, but in the vast majority of cases, it is possible to get the leg lengths close enough that the patient does not notice any difference in between the two legs.
The one exception to this is if the hip with the arthritis seems longer than the other hip before surgery. In general, it is very difficult to make a hip shorter at the time of hip replacement because the hip would no longer be stable. If the leg on the side with the hip that has the arthritis feels longer than the other leg, this will be the case after surgery as well.
The main goals of hip replacement are stable hip implants and pain relief. Leg-length equality is a priority only after the first two goals are established. It therefore is not always possible to make patients’ legs equal in length after hip replacement.
Fracture around the Hip Implants
Hip replacement parts in the United States are most often press-fit into the bone at the time of surgery. During or after surgery, it is possible to develop cracks in the bones where the implants are pressed into place. If the cracks are observed at the time of surgery, they can be addressed at that time. However, sometimes cracks develop after surgery.
To limit these problems, we use special implants and techniques to avoid fractures. In addition, we ask that patients use some form of assistive device, a walker, crutch, or cane for 6 weeks after hip replacement surgery to provide additional support to prevent twisting or falling that could produce a fracture around the hip implant.
Hip replacement can temporarily worsen any particular medical condition that a patient has. The most frequent medical complications associated with hip replacement are blood clots. We take specific steps to prevent blood clots during and after hospitalization, but clots can occur and do require treatment. In addition, patients who have heart or lung disease might note worsening of these conditions, such as heart attacks, problems with breathing, or stroke, after joint replacement.
All these complications are very rare. However, they can occur and it is important to work with your primary care physician to optimize your health before undergoing hip replacement.
Hip replacement is an extremely successful operation. In the vast majority of cases, patients do not experience any complications. In deciding whether hip replacement is right for you, it is important to know the complications that can occur and the alternatives for treatment. We are more than happy to discuss these with you. Most of the time, hip replacement is an entirely elective operation and can be done in the patient’s time frame. Knowing the risks, benefits, and options will help you to be included as part of the care team and will help you to get the most out of your hips.
To make an appointment with one of our orthopedic specialists or to learn more about our services, centers and treatment options, please call 410-448-6400.