5 Problems With Hip Replacement Surgery

Hip replacement surgery is a safe and effective treatment for severe hip arthritis, but not everyone who has surgery has a perfect result. The good news is that the vast majority of patients find significant pain relief and improvement in function after having hip replacement. But there are risks of joint replacement surgery. Patients should discuss these concerns with their surgeon prior to surgery as they decide if the time is right to have a hip replacement. In those patients with minimal symptoms, it may not be worth the risk to have surgery, but others may be willing to accept the risk of possible complications.

It is important that patient having hip replacement surgery understand the possible complications of hip replacement, understand how likely these complications are, and learn what can be done to prevent these complications from happening. It is good to ask your doctor questions before having any procedure, and they should be able to answer any concerns you have.


leg length
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After hip replacement surgery, some patients find their leg length has changed. This may sometimes correct a leg length difference from before surgery, or it may cause lengthening of the leg that had surgery. Surgeons try to restore normal leg lengths, but sometimes restoring a perfect symmetry is not possible. You should discuss with your surgeon if this problem is likely to occur before your replacement.



X-ray of a dislocated hip replacement. Image © Jonathan Cluett, M.D.

Dislocation of a hip replacement occurs when the ball comes out of the socket of the replacement. This complication is becoming less common over time as the design of hip replacement implants is changing. In addition, some surgeons advocate for different surgical approaches to the hip, such as anterior hip replacement, to reduce the chance of this complication. Your surgeon may recommend hip precautions to limit the chance of dislocation after surgery.



scalpel hand surgery
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Infection of a hip replacement is a serious complication. The best efforts are to try to do everything possible to prevent infection from occurring. When an infection does occur, aggressive treatment is needed. If the infection involves the replaced hip, repeat surgery is almost always necessary. Even with aggressive treatment, multiple surgeries, and prolonged antibiotics may be needed to eradicate the infection.



blood clot
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Blood clots occur in the large veins of the legs after major surgery, and may cause a more serious problem called a pulmonary embolism if the clot travels to the lungs and interferes with breathing. Fortunately, these are rare, and with both pharmacologic (anti-clotting drugs) and mechanical (compression socks, squeezing boots, walking) treatments, most blood clots can be prevented from occurring.



Hip Replacement Template
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Patients and surgeons both want to put in the best implant: one that will last a long time and have no problems. New implants are always being developed in hopes of engineering a better hip replacement, but sometimes newer isn't better. In fact, some new implants may turn out to be worse than implants that have a good track record. Recent problems with metal-on-metal hip replacements led to a recall of some of these designs. Most patients should look for a modern implant with a track record of years of success.


Closing Thoughts

Complications of hip replacement are uncommon, but it is important to understand these possible problems so that you can take steps to help prevent them from happening. Learn about these complications, ask your surgeon to discuss preventing them with you, and ask questions to make sure you understand everything you need to know before you have hip replacement!

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