Total Hip Replacement Complications

Original Editor - lucinda hampton

Top Contributors - Lucinda hampton, Rana Samy Algarhy, Kim Jackson and Vidya Acharya  

Introduction

Total hip replacements in experienced hands provide very effective outcomes, however one must be aware of the potential complications of the procedure. These can be divided into general and procedure specific, and may occur during the surgery, immediately after the surgery or after weeks, months, or years after the surgery. The most common systemic complication is a deep vein thrombosis. Infection is the most dreaded complication. Leg length is a common causes of patient dissatisfaction. Other complications include:

• Aseptic loosening: considered to be the most common indication for revision surgery
• Infection of hip prostheses
• Particle disease / histiocytic reaction / aggressive granulomatosis
• Fracture: periprosthetic fracture; cement fracture; stem fracture
• Dislocation (~5% of all replacements): dislocation of femoral head out of the cup: component dissociation: dislocation of the entire acetabular cup; dislocation of stem
• Heterotopic bone formation

• Reaction to metal: eg metal-on-metal pseudotumour, metallosis.
• Abductor muscle/tendon dysfunction e.g. tears
• Stress shielding
• Trochanteric bursitis
• Revision total hip arthroplasty
• General post-orthopaedic surgical complications eg haemorrhage, wound complications, deep vein thrombosis and pulmonary embolism, vascular injury, neurological deficit, death.

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Orthopaedic surgeon Mr Nick de Roeck talks about possible complications that can occur with hip replacement surgery.