Wednesday, January 18, 2012

Hip Replacement Complications

Close to 200,000 hip replacement surgeries are performed each year in the United States. Over 90% are successful with no hip replacement complications during or after surgery. But as with all surgeries, the risk of complications is always a possibility. However, complications are infrequent and often reversible.

The older the person is the higher the risk of complications. A person over 80 years old has a 20% chance of developing at least one complication after hip replacement surgery.

Hip replacement complications during surgery

Nerve damage

The sciatic nerve is at risk of being accidentally surgically cut due to its close proximity to the capsule of the hip joint. This same nerve may also become over-stretched during hip manipulation during chirurgia.

Dipende dall'entità del danno nervo, possono provocare danni permanenti o temporanei. Ci può essere la perdita di forza muscolare e la sensazione in parti della gamba. Si può richiedere a 6 mesi o più per il recupero. La maggior parte dei pazienti hanno alcuni intorpidimento intorno a loro sito di incisione che può essere permanente.

Danno vascolare

Il danno coinvolge trauma diretto per i vasi sanguigni nella zona della chirurgia. Vaso sanguigno danneggiato possono essere riparato da un chirurgo vascolare, se esso viene catturato nel tempo.

Frattura del femore

Forza applicata durante la procedura chirurgica. Questo può provocare una frattura del femore albero, soprattutto in pazienti anziani o osteoporotica. Ancora una volta, il problema è affrontato durante l'intervento chirurgico, ma può portare alla riabilitazione estesa. Il chirurgo può mettere il cuscinetto di pesorestrictions while you are walking.

Leg length discrepancy

In some cases, it may be difficult to get the exact same leg lengths. The result is usually a longer leg on the surgical hip. It may be unavoidable and deliberate in order to improve muscle function or stabilize the hip. If there is more than a quarter of an inch difference, a shoe lift may be necessary.

In some patients, both legs are the exact same length but they think their surgery leg "feels" longer. In most cases this "feeling" goes away as the patient adjusts to their new hip.

Rarely does shortening of the leg occur. If the leg is significantly shortened after surgery, it may have dislocated.

Anesthetic complications

Complications can occur, and in rare cases even death. Your anestesista vi spiegherà i rischi prima di tuo intervento chirurgico.

Complicazioni di protesi d'anca dopo l'intervento chirurgico

Coaguli di sangue (trombosi venosa profonda DVT)

Questa è una delle complicazioni più comuni dopo la sostituzione dell'anca. L'area più comune è il vitello. Dolore alle gambe maggiore è di solito il sintomo più evidente. Arrossamento intorno alla zona dei coaguli può verificarsi anche. È un problema minore se la formazione di coaguli rimanere alla gamba. Ma se essi sloggiare, essi possono raggiungere i polmoni (embolia polmonare) e può causare morte (molto raramente).

Se i vostri sospetti chirurgo coaguli di sangue, egli sarà immediatamente per un'ecografia per confermare o escludere i coaguli. La maggior parte dei chirurghi ordinerà il riposo a letto fino a quando i risultati del test vengono torna positivo o negativo per i coaguli di sangue. Egli prescriverà un sanguethinner. Compression boots and ankle/leg exercises help reduce the chance of blood clots.


Infection can occur during surgery or develop afterwards. It is one of the most serious risks to the joint replacement. If the infection settles deep into the joint and surrounding tissues, the new joint often has to be removed until the infection clears with treatment. If the patient develops an infection elsewhere in the body (bladder, teeth, chest), it must be controlled to prevent the possibility of it spreading through the blood to the new joint.

If you have rheumatoid arthritis or diabetes, or have been taking cortisone for a long time, you are more prone to infection in the weeks following your surgery.

Infection can occur many years after the surgery. Bacteria can travel through the bloodstream from an infection in other parts of your body (bladder infection, infected wound, kidney infection). Oral antibiotics may need to be taken before and after routine dental work years after your hip replacement operation.

Hip dislocation

The first six weeks after hip replacement is the most vulnerable time for your new hip. During this period, muscle tension is the only thing holding the metal ball in the socket. If the metal ball slips out of the socket, it's dislocated. As the hip muscles regain their strength and scar tissue forms around the ball, the risk of hip dislocation diminishes.

Traditional hip replacement requires that certain precautions be taken and some positions/movements are restricted, at least for the first 6 weeks. Your surgeon and physical therapist will instruct you in your hip precautions. Basically, the precautions are:

do not turn your toes inward do not cross you legs do not bend your hip more than 60-90 degrees (when sitting, your knee should not be level with your hip, it should be lower)

If dislocation occurs, call an ambulance to get you to the hospital. Your surgeon will pop the hip back into place. If it happens frequently, a hip brace worn for several months will prevent further dislocations. Hip replacement using the anterior approach eliminates the need for hip precautions or restrictions of positions/movements.

Those people who are overweight or have weak muscles are more prone to dislocation. Avoid heavy exercise that puts too much stress on your new hip (running, playing basketball, tennis, heavy lifting). Instead, participate in activities such as walking, swimming, stationary bike.

Trochanteric problems

Your greater trochanter, a large boney part of your femur, is located below and to the outside of the ball of your hip joint. Many of your large hip muscles anchor on the trochanter, so it's essential for normal hip function.

During lateral approach surgery, the trochanter is detached to access the hip joint. It's then reattached. If the trochanter does not heal back on the femur bone, it remains as a separate piece. This may result in pain, weakness, and loss of hip function.

Bowel complications

Constipation frequently occurs for the first week or so after surgery. This can be caused by medication, immobilità, perdita di appetito, non bere abbastanza fluidi. Emollienti delle feci o clisteri possono essere necessari.

Problemi urinari

Un catetere può essere inserito durante l'intervento chirurgico. Il medico sarà per la sua rimozione non appena com'è pratico, come cateteri pongono un aumentato rischio di infezione urinaria.

Formazione di ematoma

Durante l'intervento chirurgico, le principali aree di sanguinamento sono controllate da cauterizzazione. Ma ancora alcuni stillicidio di sangue e fluidi avviene, così uno scarico è attaccato dalla ferita all'esterno del corpo. Se la fuga non funziona come previsto, una raccolta di sangue e fluidi forme nell'area dell'anca. Ciò può causare dolore e pressione possibile infezione. Il chirurgo può richiedere indietro alla chirurgia per drenare l'ematoma.

Allentamento della protesi

Sono le ossa più difficile, illonger your hip replacement will last. Hard bones create a stronger bond. People with rheumatoid arthritis and osteoporosis are more at risk.

Running and heavy impact activities can also loosen the bond of the implant. Keep your weight down, as this will put more stress on the hip joint. Every pound you gain adds three pounds of force on your hip.

Choose a surgeon who has performed many hip replacements. Talk to some of his previous patients to see how they are doing after their hip replacement. Not all surgeons are alike. I have seen a few hip revisions that were necessary only because the initial hip replacement was done poorly by the original surgeon.

Pressure sores

In the immediate days after your hip replacement, you may be spending quite a bit more time in bed. Spending a long period of time in one position can lead to pressure sores. Your heels, especially on your surgery leg, are very susceptible. A pillow or towel roll under your calves will float your heels and relieve pressure. The elderly are especially prone to pressure sores because their skin is softer and they do not move around as well. A close eye should be kept on their heels and tailbone area, and should be regularly repositioned in bed with pillows.

Blood transfusion complications

All blood intended for use in transfusions is screened for Hepatitis B virus, Hepatitis C virus, syphilis, Human T Cell Leukemia virus, and the AIDS virus. But infections still occur. Hemolytic Transfusion Reaction occurs due to incompatibility with the donors blood type. The most common cause of Hemolytic Transfusion Reaction is clerical error (mislabelled specimen or improperly identifying the patient receiving the blood).

If you plan to use your own blood for possible transfusion, let your doctor know ahead of time so arrangements can be made. Your blood can only be stored for 35 days. Collection should begin at least 10-14 days before your surgery. The final collection occurs not later than 5 working days before the surgery date. Your blood will be screened as well.

About hip revision surgery

Most people who undergo hip replacement surgery will never need to replace their artificial joint. But because more and more people are having hip replacements at a younger age, the wearing away of the joint surface can create problems. After 15-20 years of wear e lacrima, sostituzione (chirurgia di revisione) dell'articolazione artificiale è sempre più comune. Chirurgia di revisione non ha come bene un risultato come la chirurgia iniziale.

Prima di decidere sulla chirurgia in considerazione tutte le complicazioni di protesi all'anca. Questo non è un elenco completo dei rischi, come ci possono essere qualche rare complicazione non menzionati qui.

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