Hip complications

Post-surgical hip dislocation

One of the most serious complications following a hip replacement operation (hip arthroplasty) is dislocation of the new hip joint while a patient is rehabilitating.

To perform a hip replacement a surgeon needs to make an incision through the gluteal muscles as well as the soft tissue capsule of the hip joint. For a period of time after the operation this means that these tissues are weaker than normal. This is the period when hip replacement complications are most likely to occur.

In addition, the gluteal muscles, which normally stabilise the hip joint, are unable to contract properly due to pain and healing.

Limb length discrepancy may be a sign that a hip dislocation has occurred, such as a posterior dislocation. This may be the result of joint loosening.

The complications of hip replacement surgery may be higher for those individuals undergoing a revision hip replacement or with certain, pre-existing hip joint structural problems.

Hip replacement wear

The metal and plastic components of a hip replacement do not last forever. For most patients that have undergone a hip replacement, the implants will have to be replaced after 15 to 20 years. The metal and plastic hip replacement can lead to complications due to natural wear and tear on the hip joint. Factors that may reduce the lifespan of a hip replacement include:

•  Hip replacement performed in younger patients (possibly due to a higher activity level).
• Poor rehabilitation following surgery.
• An unstable hip replacement prosthesis (the hip may feel weak or dislocated after surgery).
• Obesity.

Revision hip replacement complications may be a sign that the hip replacement is wearing out. If a worn prosthetic hip joint isn’t replaced then it can lead to a dislocated hip.

Although there is some evidence to suggest activity levels do affect the lifespan of a hip replacement, most hip replacements fail through a process known as prosthetic loosening.

Hip revision surgery complications may be more related to a reaction and subsequent softening of the bone surrounding the metallic components of the hip replacement. Evidence suggests this is independent of the activity level of the hip in some studies.

Other post-surgical hip complications

As with any general hip surgery, there may be complications arising from the anaesthesia used during the procedure. Your anaesthetists and surgeons will discuss these with you prior to surgery.

Following surgery, our nursing staff and expert physiotherapists will work with you to ensure that you are mobile as quickly as possible. This will help to reduce any risks of respiratory complications.

Total hip arthroplasty complications can occur even with the minimally invasive incisions that are used for hip surgery. Infection of the hip joint is one possible complication.

Non-surgical hip complications

Complex, structural hip problems are not just related to surgery. Unfortunately, several different medical problems can affect the hip joints.

Hip dysplasia is a condition that can develop in the early years of life. This occurs when the hip joint is not fully located in the socket, so that the hip joint does not develop properly. Hip dysplasia can be treated in several ways, both surgical and non-surgical, depending on how early the condition is diagnosed.

Other problems, which if left untreated, can lead to early hip degenerative changes, these include immune system disorders such as rheumatoid arthritis as well as interruption to the blood supply to the hip joint, which is called ostenecrosis.

Again, early and accurate diagnosis is the key to getting a good long term outcome for these conditions, which our experienced hip consultants can provide.

• Pain in the hip. This can be when sitting or walking.
• Limping when walking, possible due to leg length discrepancy.
• Reduced movement in the hip joint.
• Referred pain (may be felt in the leg).
• Muscle stiffness.
• Pain when you apply weight on a leg.
• Weakness in the hip when doing certain activities or a feeling that the joint is loose.
• In severe cases, you may have a hip joint dislocation.
• Infection following hip surgery or blood clots.
• Hip replacement complications of leg length.

The most common dislocated hip symptoms to look out for are pain in the hip and difficultly putting weight on a leg.

It is important to see your doctor if you are experiencing any of these symptoms and obtain hip dislocation treatment.

If you are suffering from post-surgical hip complications then you should see a doctor as soon as possible. During a consultation with one of our experienced hip orthopaedic consultants, the specialist will take an in-depth look at the history of the problem, followed by a physical examination.

X-rays and sometimes more specialist diagnostic scans, such as CT scans, will be organised in the event of a hip joint dislocation and other suspected cases of structural hip deformity or failure of the prosthesis. In some cases blood tests may be organised to exclude any hip joint infection.

Along with a course of physical therapy to build muscle strength and improve mobility, treatments for hip complications include:

• Pain relief medication will help you to manage and reduce the level of hip pain. Your doctor may suggest using a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen.
• A course of antibiotics will be used to treat any infection.
• Hip replacement dislocation treatment will either involve a closed or open reduction. The hip joint can be manually reset in a closed reduction, which means without surgery. An open reduction means resetting the hip joint through surgery.
• There are a variety of surgical treatments available. The treatment offered to you will depend upon the exact nature of the problem. However, the most common procedure to treat a hip complication is a total hip replacement.