Leg length inequality (hip specific)
It is very difficult to make the leg exactly the same length as the other one. Occasionally the leg is deliberately lengthened to make the hip stable during surgery. There are some occasions when it is simply not possible to match the leg lengths. All leg length inequalities can be treated by a simple shoe raise on the shorter side.
Anesthetics are necessary for performing total joint surgery. In general, most patients receive a spinal anesthetic. Some patient not suitable for spinal anesthetics receive general anesthesia. A very small number of patients have problems with anesthesia. These problems can be reactions to drugs used, problems related to their medical complications and problems due to anesthesia. Be sure to discuss the risks and concerns with your anesthesiologist.
This may occur in the hospital, after you return home or years later. This occurs in less than 1% of the patients. While many steps are taken to minimize the risk of infection, it can be avoided altogether. In the hospital, you will receive antibiotics for 24 hours during and after surgery to help prevent infection. The operating room is a filtered, clean air environment, and the limb is washed, prepared with antiseptic solution and covered with sterilized drapes.Our surgical team wears masks, sterilized gowns and two pairs each of sterilized gloves that are frequently changed. Some operating rooms have special air conditioning filters. Your surgical team may also wear special space suit like gowns.For two years, you will need to take antibiotics before undergoing even minor procedures to reduce the chances of infection in another part of your body from spreading to the artificial joint. If an infection does occur, your surgeon will have a protocol to manage it.
These may result from several factors, including decreased mobility following surgery, which slows the movement of blood. The blood clots can form in the legs, hips, and pelvis. Symptoms include redness and swelling of the leg, especially in the calf area, and shortness of breath.You can prevent blood clots with:
- Blood thinning medications (anticoagulants) for 10 days post- operatively OR possibly 21 days if you have risk factors
- Elastic support stockings to improve blood circulation
- Elevating the feet and legs to keep blood from pooling
- Moving toes and legs immediately after surgery
- Out of bed the afternoon of surgery and then as tolerated
This can occur when preparing the bone surfaces for and implanting the artificial components. The risk is higher when bones are weakened by previous surgery.
This is always a risk following major surgery. You will be assigned a series of deep breathing exercises to keep your lungs clear.
Dislocation and instability (hip specific)
An artificial hip joint is held in place by your own muscle. Stability also depends on the position in which the hip is placed by your surgeon.Dislocation can damage the artificial joint and cause early failure and revision surgery. This is most likely to occur within the first 6-12 weeks after the surgery. There are specific precautions you must follow; while sleeping, washing, bending and toileting. As time goes on, the risks are reduced; however, some precautions remain.If your hip comes out of joint it must be put back in place. This usually requires a very brief general anesthetic while the leg is firmly pulled until the artificial hip drops back in place. You may be able to avoid further problems by avoiding at risk positions.
A Brownish red fluid may drain out of your incision around 2 weeks after surgery. This is a common occurrence and you should not be alarmed by this drainage. Clean the incision with hydrogen peroxide, replace the dressing and notify your surgeon.
Nerve and vessel injury
There is a 0.7 % chance of neurological stretch injury at the time of surgery. The sciatic and femoral nerve, located adjacent to the hip, is vulnerable to injury and on rare occasions may cause weakness or loss of feeling about the foot.
The major reason artificial joints eventually fail continues to be a process of loosening where the metal or cement meets the bone. Great advances have been made to extend the life of an artificial joint, with many patients reporting excellent function for many years. If the pain of a loose joint becomes unbearable, another operation may be required to revise it.
Although every effort has been made to explain the complications there will be complications that may not have been specifically mentioned. A good knowledge of this operation will make the stress of undertaking the operation easier for you to bear.
The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery.
You must not proceed until you are confident that you understand this procedure, particularly the complications.