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Risks Related to Joint Replacement Surgery
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Hip Replacement
The most common complication of hip replacement is that something goes wrong with the joint, which occurs in around 1 in 10 cases.

1. Joint problems
Some common types of joint malfunctions are listed below:

 Loosening of the joint
The most common problem that can arise as a result of a hip replacement is loosening of the joint. This can be caused by the shaft of the prosthesis becoming loose in the hollow of the thigh bone, or due to thinning of the bone around the implant.

Loosening of the joint can occur at any time, but it normally occurs 10-15 years after the original surgery was performed.
Signs that the joint has become loose include pain and feeling that the joint is unstable.
Another operation (revision surgery) may be necessary, although this cannot be performed in all patients.


 Hip dislocation
In around 3% of cases the hip joint can come out of its socket. This is most likely to occur in the first few months after surgery when the hip is still healing.
Further surgery will be required to put the joint back into place.


 Wear and tear
Another common complication of hip replacement surgery is wear and tear of the artificial sockets. Particles that have worn off the artificial joint surfaces can be absorbed by surrounding tissue, causing loosening of the joint.
If wear or loosening is noticed on X-ray, your surgeon may request regular X-rays. Depending on the severity of the problem, you may be advised to have further surgery.
There have been reports about metal-on-metal implants wearing sooner than expected and causing complications. You can consult your doctor for further advice if you have any concerns about your hip replacement or do not know which type you have.


 Joint stiffening
The soft tissues can harden around the implant, causing reduced mobility. This is not usually painful and can be prevented using medication or radiation therapy (a quick and painless procedure during which controlled doses of radiation are directed at your hip joint).



2. Serious complications
Serious complications of a hip replacement are uncommon, occurring in fewer than one in a 100 cases.
These are described below.


 Blood clots
There is a small risk of developing a blood clot in the first few weeks after surgery.
There are two main places a blood clot can develop:
  • inside one of your legs – which is known as a deep vein thrombosis (DVT)
  • inside your lungs – which is known as a pulmonary embolism
Symptoms of a DVT include:
  • pain, swelling and tenderness in one of your legs (usually your calf)
  • a heavy ache in the affected area
  • warm skin in the area of the clot
Symptoms of a pulmonary embolism include:
  • breathlessness, which may come on suddenly or gradually
  • chest pain, which may be worse when you breathe in
  • coughing
If you suspect that you have either of these types of blood clots you should seek immediate medical advice from your GP or the doctor in charge of your care. If this is not possible then call your local out-of-hours service.
In order to reduce your risk of blood clots you may be given blood thinning medication such as warfarin, or asked to wear compression stockings.


 Infection
There is always a small risk that some bacteria could work its way into the tissue around the artificial hip joint, triggering an infection.
Symptoms of an infection include:
  • a high temperature (fever) of 38°C (100.4°F) or above
  • shaking and chills
  • redness and swelling at the site of the surgery
  • a discharge of liquid from the site of the surgery
  • hip pain that can persist even when restingSeek immediate medical advice, as detailed above, if you think you may have an infection.
 

Knee Replacement
As with any operation, knee replacement surgery has risks as well as benefits. Most people who have a knee replacement do not experience serious complications.

After having a knee replacement, contact your doctor if:
  • you develop hot, reddened, hard or painful areas in your legs in the first few weeks after your operation–although this may just be bruising from the surgery, it could mean a blood clot has developed
  • you experience chest pains or breathlessness–although it is very rare, you could have a clot on your lung (pulmonary embolism)which needs urgent treatment

1. Anaesthesia Associated Risks
Anaesthetics are extremely safe, but carry a risk of minor side effects such as sickness and confusion (usually temporary). There is also a slight risk of serious complications.
The risk of death in a healthy person having routine surgery is very small. Death occurs in around one in every 100,000 general anaesthetics given.
The risk is higher if you are older or have other health conditions, such as heart or lung disease.
Your anaesthetist and surgeon can answer questions you may have about your personal risks from anaesthetic or the surgery itself.


2. Other complications
Complications occur in about one in 20 cases, but most are minor and can be successfully treated. Possible complications are described below.
  • Infection of the wound–this will usually be treated with antibiotics, but occasionally the wound can become deeply infected and require further surgery. In rare cases it may require replacement of the artificial knee joint
  • Unexpected bleeding into the knee joint
  • Ligament, artery or nerve damage in the area around the knee joint
  • Blood clots or deep vein thrombosis (DVT)–clots may form in the leg veins as a result of reduced movement in the leg during the first few weeks after surgery. They can be prevented by using special support stockings, starting to walk or exercise soon after surgery, and by using anticoagulant medicines
  • Fracture in the bone around the artificial joint during or after surgery–treatment will depend on the location and extent of the fracture
  • Excess bone forming around the artificial knee joint and restricting movement of the knee–further surgery may be able to remove this and restore movement
  • Excess scar tissue forming and restricting movement of the knee–further surgery may be able to remove this and restore movement
  • The kneecap becoming dislocated–surgery can usually repair this
  • Numbness in the area around the wound scar
  • Allergic reaction–you may have an allergic reaction to the bone cement if this is used in your procedureIn some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.
 Source: http://www.nhs.uk/