This article is part of the the Ultimate Guide to Hip Pain Relief.
Many patients that experience hip pain may at one point need to consider surgery. Researching and having an open conversation with your doctor can help to answer your questions and learn more about the surgery. One area that should be addressed is the surgery risks and potential complications.
IBJI recently chatted with Dr. Peter Thadani, board-certified orthopaedic surgeon with fellowship training in adult hip and knee reconstruction and total joint replacement. Dr. Thadani educates patients on hip surgery risks and potential complications for total hip replacement. His responses—below—have been edited and condensed for space
Total hip replacement surgery has been called “the operation of the century” 1 due to its success in relieving pain and improving function in patients with debilitating hip arthritis. Dr. Thadani says that, “More than 90% of patients who undergo hip replacement achieve significant pain relief. However, it is a major surgery, and there are certain risks and complications that can occur during or after the procedure.”
With all surgeries there is a risk of complications. It’s important to discuss these with your doctor before going into surgery. The complications for total hip replacement can be classified as general or procedure specific.
Some general complications patients should be aware of include urinary complications (urinary tract infection or urinary retention after surgery), as well as cardiovascular complications (heart attack or stroke).
“With thorough preoperative health optimization and preparation, including management by one’s primary care physician, the risk of serious or catastrophic complications is extremely low,” says Dr. Thadani.
Procedure Specific Complications
For total hip replacement, there are a few short term procedure specific complications to be aware of. After surgery a blood clot can develop in the leg, known as deep vein thrombosis (DVT). There is a possibility that the clot could travel to the heart and then into the lungs, forming a pulmonary embolus (PE).
Dr. Thadani says, “Most DVT’s and PE’s do not pose a serious threat to one’s health; it is much less common that they result in catastrophic respiratory failure or fatal cardiac arrest. Fortunately, the rate of developing a PE is less than 0.25% with use of blood thinners after surgery2.”
Another procedure specific complication is infection. An infection can develop in the hip after surgery and can potentially be quite serious. “If an infection develops it can require multiple additional surgical procedures in addition to intravenous antibiotics,” says Dr. Thadani, “Although infections are uncommon (0.3-1.5%3), they can cause significant disability and pain that can occasionally be permanent.
“For this reason, the surgical team takes every precaution possible to prevent infections at the surgical site. It is important as a patient to understand that certain health factors such as obesity, uncontrolled diabetes, and tobacco use are risk factors for infection and that improvement of these health issues can significantly lower the risk.”
Advancements to Reduce Risk and Complications
Dr. Thadani says that, “Advances in implant technology and materials, as well as modern surgical techniques, have reduced the risk for complications such as dislocation of the hip ball out of the socket after surgery or a noticeable discrepancy in the lengths of the two legs after surgery. Advances have also been made in perioperative patient care, including blood conservation strategies that make the risk for a blood transfusion after hip replacement extremely low and have virtually eliminated the need to donate and store blood prior to surgery.”
“Additional complications related to technical factors of the surgery include potential fracture of the femur (upper thigh bone) and nerve injury,” adds Dr. Thadani, “The incidence of a femur fracture is approximately 0.5-1.5%4 and is related to patient age, gender, bone quality, and the surgeon’s choice of implant and surgical technique. Nerve injuries can occur up to 1.9% of the time5, but the majority of these are minor nerve stretches or bruises that usually recover; the risk for permanent nerve damage is much lower.”
Hip Replacements Overtime
Overall, total hip replacement devices are very durable and typically provide pain free service for many years. “Although 93-95% of patients report significant pain relief, a small percentage of patients may continue to experience chronic hip pain even after the surgery. A couple of additional long term procedure specific complications should be noted as well. Over time, the prosthetic materials can wear out or the prosthesis may loosen from the bone, causing pain that may require a second operation. However, nearly 80% of hip replacement implants will last for at least 25 years6.”
While millions of patients worldwide have enjoyed the success associated with total hip replacement, it’s important to be aware of the potential risks and complications that can occur during or after surgery in order to make a decision as to whether surgery is the right choice for you.
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Hip Care and Treatment at IBJI
Whether you are just starting out in your hip care journey or need a second opinion for your hip pain, IBJI’s hip surgeons are here to help provide you with the necessary care for your ailment. Get the relief you are seeking with the help of IBJI.
Request an appointment with an IBJI hip surgeon to discuss treatment options and create an individualized approach to your care.
*The blog is for general information and educational purposes only regarding musculoskeletal conditions. The information provided does not constitute the practice of medicine or other healthcare professional services, including the giving of medical advice, and no doctor-patient relationship is formed. Readers with musculoskeletal conditions should seek the advice of their healthcare professionals without delay for any condition they have. The use of the information is at the reader’s own risk. The content is not intended to replace diagnosis, treatment or medical advice from your treating healthcare professional.
- 1 Learmonth ID et al, The Lancet, 2007
- 2 Lieberman JR et al, Journal of Arthroplasty, 2017
- 3 Blom AW et al, Journal of Bone & Joint Surgery, British Volume, 2003
- 4 Fleishman AM et al, Journal Arthroplasty, 2019
- 5 Brown GD et al, American Journal of Orthopedics, 2008
- 6 Evans JT, The Lancet, 2019
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