Risks

Risks of hip replacement

Hip replacement is one of the tried and tested operations in medicine. It is generally safe. As with any other surgical procedure, it has some risks. These are classified as early and late.

1) Blood clots syn Deep vein thrombosis - During surgery or afterwards, clots can form in the leg. This is a result of pressure on the leg veins. Clots can result in swelling of the leg after surgery. These clots can also migrate from the legs to the lungs where they can cause significant problems. I take proper precautions based on my assessment of each individual case. I use blood thinner drugs, exercises and pressure stockings to prevent clot formation. My patients are able to mobilize rapidly which reduces the risk of clot formation.

2) Fractures - There is a risk of fracture during hip replacement surgery with osteoporotic bone. Small fractures may be left alone. Bigger fractures if identified during surgery are fixed with devices and/ or to stabilize the bone.

3) Infection - As with any implant surgery, there is a risk of infection with hip replacement. I use preventive measures like pre-operative antibiotics, surgical attire, proper operating room etc to lower the risk of infection. I monitor the wound very carefully after the operation on a regular basis. If I suspect an infection, I may have to take you back to the OR to clean out the hip. Sometimes an infection may require removal and further replacement of the implant to cure the infection.

4) Dislocation - There is a distinct risk in early days after hip replacement. Some positions of your leg can cause a dislocation. I keep the leg spread out to reduce the risk. You will be advised not to bend the leg more than 90 degrees or cross it over the other to prevent dislocation. If one does occur, you will have to be returned to the OR to put the hip back. You may have to wear a brace for a short while to allow soft tissue healing and reduce the risk.

5) Leg length difference - In simple cases there is no significant risk. However in those cases with a preexisting difference, there is a risk. I take precautions during surgery to keep the lengths the same or within acceptable limits. Sometimes it may not be possible to get an exact match. A discrepancy of up to one inch is well tolerated and acceptable.

6) Wear and loosening - The parts of your hip joint may wear over time. If you are young during your first hip replacement, you may need another one in your life. This risk can be lowered by using durable materials like ceramic hip replacements in younger patients. I also recommend my younger patients to choose a neck preserving or short stem hip replacement. This option will preserver more of your normal bone during the first operation so that more bone is available for future operations. These are more expensive than metal and plastic but are worth the investment in young patients. Another option is the Birmingham mid head replacement implant in younger patients with avascular necrosis.

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