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Complications of Hip replacement

Loosening of the joint, especially after about ten years, has been a major problem that has so far defied solution. The shaft of the prosthesis becomes loose in the hollow of the thigh-bone or becomes dislocated. Re-operation (revision surgery) is necessary in around 10% of all total hip replacement cases.

Because of the tendency to loosening, and because this is more likely if the joint is heavily stressed, hip replacement is not commonly performed in young and physically active patients. Some surgeons reserve total hip-joint replacement for patients over 60.

Another common later complication of hip replacement surgery is inflammation due to a reaction to particles that have worn off the artificial joint surfaces and absorbed by surrounding tissue. The bone may get eroded causing the implant to become loose. Anti-inflammatory drugs may stop the problem, but if not, revision surgery may be advised.

Less common complications include:

  • Loosening of the new joint, or wearing away of the joint or bone next to it.
  • Infection – this has been reduced by giving antibiotics at the time of surgery, and by using 'clean air' ventilation in theatre, but still occurs in around 10% of cases.  Deeper infection is serious and requires removal and re-implantation of the joint.
  • Blood clots forming in the deep veins of the leg (deep vein thrombosis); rarely they can detach and get stuck in the lungs (pulmonary embolism).
  • Abnormal bone growth beyond the normal ends (heterotopic bone formation).

Very little information is available on the long-term safety and reliability of MoM hip resurfacing as it is a relatively new technique. A National Joint Registry will monitor people who have had MoM hip resurfacing to see if it meets a target of less than 1 in 10 devices needing replacing after 10 years. Your surgeon should explain the risks and benefits associated with MoM hip resurfacing if you are suitable to have this operation.