What are the risks associated with hip replacement surgery?

Hip osteoarthritis can be a debilitating condition, causing significant pain and restricting mobility. If measures such as painkillers and exercise are not enough to keep the symptoms at bay, hip replacement surgery can be an extremely effective treatment. Over 100,000 hip replacements are performed each year in the UK according to the UK national joint registry.

Like all surgery, hip replacement surgery carries some risks and surgeons will go through these before you have the operation. The main risks are:

• Infection – antibiotics alone are usually not sufficient to treat an infected hip replacement and further surgery is often required. Prevention is key.
• Nerve injury – injuries to the major nerves around the hip is extremely rare, but can affect mobility and reduce sensation in the leg.
• Fracture – broken bones can occur around hip replacements, this can rarely occur during the operation but is more commonly due to falls after surgery.
• Dislocation – this is the term for when the ball of the hip replacement pops out of the socket. It is rare with modern hip replacement implants and techniques.
• Leg length differences – legs can feel different lengths after hip replacement surgery. Sometimes this is because the surgeon has actually changed the length of the leg to improve stability, but conditions like tilting of the pelvis or curvature of the spine can make it feel like legs are different lengths even if they are not.
• Bleeding – some bleeding and bruising is expected, blood transfusions are very occasionally required.
• Implant loosening – hip replacements can loosen from the bone, usually after several years, causing pain or dislocation.
• Medical or anaesthetic risks – before an operation medical checks are performed to make sure your body is as fit as possible.
• Deep vein thrombosis – blood clots in the deep veins of the leg, these can be serious and medication will be given to reduce the risk.

When you have a hip replacement, the team looking after you will be doing multiple things throughout your treatment journey to reduce all these risks. As a consequence, the vast majority of people undergoing hip replacement surgery will suffer no significant complications. However, as a patient, there are things you can do to reduce your risk:

• Get as fit and healthy as possible before surgery
  • Losing weight and stopping smoking can substantially reduce the risk of complications.
  • Building strength and maintaining mobility before surgery will help you get back on your feet faster after the operation, reducing the risk of medical complications and deep vein thrombosis. Versus Arthritis offer advice on how to do this.
  • If you have long term health conditions like high blood pressure or anaemia, speak to your healthcare team well in advance of surgery to make sure these are being fully treated.
  • If your teeth are in poor condition, see a dentist and complete any treatment well in advance of hip replacement surgery. This can reduce the risk of infection of the hip replacement.
• Pace yourself after surgery, pushing too hard too quickly can cause falls or muscle and tendon pain which may be difficult to treat. As a guide, increase your average step count by 10-15% per week after surgery. Avoid strenuous activity for three months.
• It is possible to ski or horse ride after hip replacement, but if you have no experience of these it may not be sensible to try to learn after surgery due to the risk of accidents.

There are many different types of hip replacement and techniques of insertion, they all have pros and cons. Choose a surgeon who specialises in hips and take their advice on what to have done. If you would like to know more about hip replacement surgery, contact our team on 02039265615 or info@gop.health to arrange an appointment with one of our specialist hip replacement surgeons.