Hip complications

Artificial hip joints, similar to all artificial joints, will with time and high usage have a limited life span. For a hip replacement where there is a high level of use, as in sporting activity or physical employment, the life span of the implant will be reduced. Most hip replacements will however have a life span of 10 to 15 years.

A hip replacement or hip resurfacing is a major operation, and as such has the acknowledged risks of such a major procedure. The Hip Unit at the BMI Bath Clinic regards each procedure as such, and treats each individual case as indeed a major operation and a major event in the life of the individual patient. The risks are not underestimated, and thoroughly assessed for each patient individually. The standard risks for such surgery are

Anaesthesia

Modern anaesthesia is however extremely safe and successful. The Consultant Bath Anaesthetic Group use a variety of anaesthetic techniques best suited to the patients. Most patients have their hip procedures under regional anaesthesia using a spinal anaesthetic, avoiding the need for a general anaesthetic. Careful postoperative monitoring ensures a high level of safety, particularly for our older patients. Patients in their 8th decade do have more pre-existing medical problems than younger patients and have thus a raised risk of non orthopaedic post operative medical problems and need to be in good health to consider hip replacement.

Infection

There is a strict infection control policy at the BMI Bath Clinic, with a high level of patient satisfaction regarding in this respect. Antibiotics are used routinely at the time of surgery, and bone cement used is also impregnated with antibiotics. However despite this, the risk of infection is still present at approximately one in one hundred.

Blot clots in the legs and on the lungs (Thrombo-embolism)

This is a potentially very significant issue in lower limb orthopaedic surgery. Indeed it is very topic and often discussed as 'economy class syndrome'. A thorough policy of using mechanical calf compression, anti-embolism stockings, low molecular weight heparin injections as an in-patient and aspirin on discharge helps minimise this risk as much as possible. The risk cannot be eliminated however. Smoking increases the risk of thrombo-embolic disease, and it is advisable to give up at least 6 weeks prior to the operation, if not forever.

Dislocation

The 'ball' of the hip joint which is a ball and socket joint, may 'pop' out of the socket. This has a reported frequency of 1 - 9%. The Hip Unit at the BMI Bath Clinic with the use of hard and larger bearings minimises this risk and quotes an incidence of approximately 1%.

Leg length discrepency

During a hip replacement the surgeons performing the operation try and balance the leg lengths of the affected and unaffected sides. The BMI Bath Clinic has a wide variety of hip implants in differing sizes to try and ensure the anatomy and leg length are restored. However this is limited by the more important goal of a stable joint replacement, and a leg length discrepancy may be unavoidable.

Fracture

Fractures around the time of implant insertion, (peri prosthetic fractures) may occur with a frequency of 1%.

Neurovascular injury

There is a remote chance of damage to the nerves and arteries around the hip (less than 1 in 100), but more so with those hips that have had previous surgery or are of a rather abnormal shape.

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