What are the Most Common Hip Replacement Complications?

R. Bargar

More than 90 percent of patients undergoing hip replacement surgery have minimal to no complications, and of the complications that do arise, almost all can be successfully treated. The most common hip replacement complications are divided into two categories. The first group occurs shortly after the procedure and include clotting, infection, dislocation and problems with wound healing. The second group of complications occurs months to years after the surgery. Long-term complications include hip replacement system failure, debris generated during frictional wear of the artificial hip and toxicity related to wear of the metal components of some artificial hips.

An X-ray of the pelvic area, showing a replacement hip.
An X-ray of the pelvic area, showing a replacement hip.

Dislocation of the prosthetic joint is the most common hip replacement complication. This happens when the ball of the joint comes loose from the socket. During the recovery period, patients should follow instructions carefully to prevent placing the leg in positions that cause dislocation. A brace can help the joint stay in place. Repeated dislocations might require corrective surgery.

Severe pain following a hip replacement surgery can be a sign of serious complications.
Severe pain following a hip replacement surgery can be a sign of serious complications.

Blood clots are one of the common hip replacement complications. Clots forming in veins are a typical problem after a mobility-limiting surgery. Lack of movement or injury to the veins during the surgery increases the risk of clot formation. Medication can prevent clotting and is frequently prescribed during the recovery period.

Failure of the prosthetic joint is a long-term hip replacement complication requiring a second surgery.
Failure of the prosthetic joint is a long-term hip replacement complication requiring a second surgery.

Infections of the incision are another hip replacement problem. Although most infections can be prevented with the use of antibiotics, infection deep in the tissue surrounding the hip replacement device might require surgery. This is a rather rare complication after a hip replacement.

Hip replacement complications related to undergoing surgery also occur. Patients who have heart problems and chronic conditions are at increased risk during general anesthesia. Pneumonia is one complication related to anesthesia.

Some problems occur long after the hip replacement surgery. Failure of the prosthetic joint is a long-term hip replacement complication requiring a second surgery. When the hip replacement system wears out prematurely, when it breaks or when the socket comes loose from the hipbone, an additional surgery is needed to fix or replace the defective prosthesis. Premature failure is a rare but serious complication.

Metal-on metal hip replacement systems might create metallic debris during frictional wear. Systems using polyethylene can also generate debris. These particles cause inflammation and other problems. Some medical professionals are concerned about the buildup of metal ions in the body caused by long-term wear of metal-on-metal systems.

Many hip replacement complications can be prevented by carefully following the doctor’s post-operative instructions. Patients should take all medications as prescribed, avoid high-impact sports and work closely with the physical therapist. If there are any unexpected problems, the patient should tell his or her doctor immediately. Severe pain, fever, shortness of breath, nausea and problems around the incision indicate complications that should not be neglected.

Maintaining a healthy weight also helps prevent hip replacement complications. Obesity increases wear and tear on the hip replacement system. Staying within recommended weight guidelines will help extend the life of the artificial hip and speed recovery.

In addition to sedating patients during the procedure, anesthesiologists ensure adequate pain management following hip replacement surgery.
In addition to sedating patients during the procedure, anesthesiologists ensure adequate pain management following hip replacement surgery.

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Discussion Comments

Lostnfound

A friend of mine has her second hip replacement surgery scheduled in a couple of months. She's only in her early 50s, but apparently, has bad joints. She's done very well with her first replacement, but the doctor said she probably will have to have the first one replaced in about three or four years. For some reason, the joint is wearing out too quickly.

She said she knew she needed to have the surgery, but she didn't want to have it over again in about ten years. She said if she did, she would wait and have both hips done at the same time.

Grivusangel

My mom had hip replacement surgery several years ago. Her main complication was swelling in the affected leg I have read where that is very common.

The other complication is limited mobility, but that's mostly her own fault. She went to rehab, did the rehab and was doing well, but after the home health nurse stopped coming, she stopped doing any kind of physical therapy, and she's paid for it. She does not walk well now, and it's primarily because she just stopped doing anything. Her doctor talked with her about being active, doing the exercises, etc., but to no avail. She didn't want to do them, so she didn't. Ergo, her mobility has suffered greatly.

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