Questions and Answers about Hip Replacement
What Are Possible Complications of Hip Replacement Surgery?
According the American Academy of Orthopaedic Surgeons,
approximately 120,000 hip replacement operations are performed each year in the
United States and less than 10 percent require further surgery. New technology
and advances in surgical techniques have greatly reduced the risks involved
with hip replacements.
The most common problem that may happen soon after hip
replacement surgery is hip dislocation. Because the artificial ball and socket
are smaller than the normal ones, the ball can become dislodged from the socket
if the hip is placed in certain positions. The most dangerous position usually
is pulling the knees up to the chest.
The most common later complication of hip replacement
surgery is an inflammatory reaction to tiny particles that gradually wear off
of the artificial joint surfaces and are absorbed by the surrounding tissues.
The inflammation may trigger the action of special cells that eat away some of
the bone, causing the implant to loosen. To treat this complication, the doctor
may use anti-inflammatory medications or recommend revision surgery
(replacement of an artificial joint). Medical scientists are experimenting with
new materials that last longer and cause less inflammation.
Less common complications of hip replacement surgery include
infection, blood clots, and heterotopic bone formation (bone growth beyond the
normal edges of bone).
When Is Revision Surgery Necessary?
Hip replacement is one of the most successful orthopaedic
surgeries performed -- more than 90 percent of people who have hip replacement
surgery will never need revision surgery. However, because more younger people
are having hip replacements, and wearing away of the joint surface becomes a
problem after 15 to 20 years, revision surgery is becoming more common.
Revision surgery is more difficult than first-time hip replacement surgery, and
the outcome is generally not as good, so it is important to explore all
available options before having additional surgery.
Doctors consider revision surgery for two reasons: if
medication and lifestyle changes do not relieve pain and disability; or if x
rays of the hip show that damage has occurred to the artificial hip that must
be corrected before it is too late for a successful revision. This surgery is
usually considered only when bone loss, wearing of the joint surfaces, or joint
loosening shows up on an x ray. Other possible reasons for revision surgery
include fracture, dislocation of the artificial parts, and infection.
What Types of Exercise Are Most Suitable for Someone with a Total Hip Replacement?
Proper exercise can reduce joint pain and stiffness and
increase flexibility and muscle strength. People who have an artificial hip
should talk to their doctor or physical therapist about developing an
appropriate exercise program. Most exercise programs begin with safe
range-of-motion activities and muscle strengthening exercises. The doctor or
therapist will decide when the patient can move on to more demanding
activities. Many doctors recommend avoiding high-impact activities, such as
basketball, jogging, and tennis. These activities can damage the new hip or
cause loosening of its parts. Some recommended exercises are cross-country
skiing, swimming, walking, and stationary bicycling. These exercises can
increase muscle strength and cardiovascular fitness without injuring the new