Total Hip Replacement Complications
Original Editor - lucinda hampton- Rana Algarhy
Top Contributors - Lucinda hampton, Rana Samy Algarhy, Kim Jackson and Vidya Acharya
Introduction[edit | edit source]
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.
Common Complications[edit | edit source]
The most common systemic complication is a deep vein thrombosis. Infection is the most dreaded complication. Leg length discrepancy is a common causes of patient dissatisfaction.[1] Other complications include:
- Aseptic loosening: considered to be the most common indication for revision surgery
- 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.[2]
Gait abnormality after THR[edit | edit source]
Despite this huge gain in functional ability and a subjective improvement in walking ability, gait patterns in patients undergoing THR improve, but rarely achieve normality. Many gait analysis studies have shown that gait patterns remain abnormal in the long term and are comparable to pre-operative gait. Range of motion was improved following THR, but in many cases remained less than normal. It is important to note that hip flexion contractures, with resultant loss of hip extension, have been shown to recur up to 1 year after total hip replacement, and is probably due to a combination of factors, e.g. persistent muscle weakness, scar tissue formation and learned gait patterns though the exact pathogenesis is unknown.[3]
Resources[edit | edit source]
Orthopaedic surgeon Mr Nick de Roeck talks about possible complications that can occur with hip replacement surgery.
References[edit | edit source]
- ↑ Park C, Merchant I. Complications of total hip replacement. InTotal Hip Replacement-An Overview 2018 Nov 5. IntechOpen. Available:https://www.intechopen.com/chapters/61241 (accessed 8.12.2022)
- ↑ Radiopedia Complications of total hip arthroplasty Available: https://radiopaedia.org/articles/complications-of-total-hip-arthroplasty?lang=gb (accessed 7.12.2022)
- ↑ Colgan, G., Walsh, M., Bennett, D., Rice, J., & O’Brien, T. (2016). Gait analysis and hip extensor function early post total hip replacement. Journal of Orthopaedics, 13(3), 171–176. doi:10.1016/j.jor.2016.03.005
- ↑ Top doctors UK. What are the possible complications of hip replacement surgery?. Available from: https://www.youtube.com/watch?v=2K0XPZ2vA0Q [last accessed 7.12.2022]
