What kind of complications may occur?

All operations involve an inherent risk – complications can also occur with hip prosthesis operations. The advantages offered, however, are usually argument enough for this surgical intervention: patients normally regain significant quality of life.

As with all operations, when replacing the hip joint adjacent structures may be injured. Of particular relevance here are major nerves such as the sciatic nerve or femoral nerve. The surgeon therefore pays special attention to these nerve structures.

During the operation, the femoral or pelvis bone may be injured, although this is rare. Depending on the bone structure and the care taken by the surgeon, hairline cracks or indeed larger bone fractures may appear in the bones. These may require further surgery to be stabilised, in such cases this extends the postoperative treatment time.

Directly after the operation, bleeding or effusions of blood may occur in the wound region. For this reason, small tubes, so-called Redon drains, are placed in the wound which allow the secretions and blood to drain away. These can be removed two to three days after the operation.

Thrombosis refers to the formation of a blood clot in a blood vessel. As a consequence, small components can become released and block the blood vessels in the lungs (embolism). In the case of surgical interventions, the risk of thrombosis is primarily increased by confinement to the bed. Thus measures to prevent thromboses are taken, these include anti-thrombosis injections and compression stockings.

In addition to the incision in the skin, the subcutaneous tissue structures also have to heal. In such cases, so-called wound-healing impairment may be experienced whereby the wound takes longer to close, and this is associated with intense pain and inflammation.

There is an increased risk of infections both before and after the operation. For this reason, nowadays bone cement which includes an antibiotic is used for the majority of hip prosthesis operations. This reduces the risk of infection of the endoprosthesis.

This refers to calcification foci in the tissue around the hip endoprosthesis which can form weeks or indeed months after the operation. These cause pain and reduced mobility – precisely the complaints which one hoped to remedy with the hip joint replacement. The administration of certain anti-inflammatory medications, such as indomethacin, diclofenac and ibuprofen, can help prevent periarticular ossification. Alternatively, radiation therapy on the affected leg can be performed as a preventative or therapeutic measure.

Certain movements or a fall can cause the femoral head to come loose from the acetabulum – the joint is dislocated. This is referred to as prosthesis luxation and results in intense pain and an inability to move the hip. Since resetting the hip joint is painful, this is usually done under anaesthetic.

In individual cases, infections or mechanical problems may cause the prosthesis to become loose in the bone just a few weeks or months after the operation. This manifests itself in pain and restricted mobility and, in part, signs of inflammation such as fever and listlessness. Antibiotics can be used to fight the infection but in the majority of cases, the damaged hip endoprosthesis must be replaced with a new one in a second operation.