RISKS AND COMPLICATIONS
As with any surgical operation, there are surgical risks, and early or late complications may occur. Some of them are discussed here. This list is not intended to frighten you ; it should help you to be aware that this operation is something serious, which may sometimes have serious consequences.
These complications, however, are quite uncommon and sensibly decrease if you will thoroughly prepare for intervention.
General risks common to any surgery
Your general condition (fatigue, anaemia, depression, etc.), ongoing treatments, diseases or deteriorations of some functions will affect the course of the operation and its consequences.
The purpose of the pre-operative anaesthesia consultation is to detect these risks and consider, if necessary, additional check-ups, precautions, or even contraindicate the operation.
Whatever precautions are taken, accidents may occur: allergy, embolism, infection, etc.
Such accidents are extremely rare: the risk is no greater than that of having an accident when driving for a visit to the doctor. These risks, however, exist, and you should be aware of them.
Risks specific to this operation
Despite care and prevention, some accidents or problems may occur during the operation, such as:
- injury to adjacent tissues (muscles, tendons);
- injury to some vessels which may result in severe haemorrhage. Blood transfusion may be necessary to make up for losses;
- injury to nerves, which may result in lasting disorders, such as partial paralysis or irradiated pain, even after re-operation;
- fracture of the femur or acetabulum, with osteoporosis as an aggravating factor.
Such fracture may require additional surgery (osteosynthesis) or postponed discharge.
Despite the pre-operative check-up, unexpected events during the operation may cause your surgeon to change the initially planned procedure and adapt the surgery:
- an haematoma may form in spite of drainageand usually it remains superficial, diffuse under the skin, and creates painless tension in the thigh. In some exceptional cases, re-operation may be required.
- phlebitis may occur despite prevention with anticoagulants. This phlebitis may leave lasting painful sequelae and may be accompanied by pulmonary embolism. Walking and continued anticoagulant treatment after the operation until you stop using crutches are often the best way to avoid these complications.
Infection of the operative site may occur despite prevention. This risk is aggravated by general fatigue or an infectious disease. poor hygiene cannot be compensated simply by having a shower the day before the operation.
Necrosis.
Re-operation will then be necessary to clean or even remove the prosthesis. Severe sequelae could persist if the infection cannot be sterilized.
After the operation, you may perceive that your legs having different lengths. If this is due to leg stiffness or pre-operative shortening, it will disappear in a few days; or it may require correction by a heel pad.
Late risks
Infection around the prosthesis spreading from a remote infected area:
- dental: caries are always associated with infection.
- urinary: urinary incontinence, cystitis, or prostate enlargement.
- pulmonary: pneumonia.
- cutaneous: boil, vein ulcer, oozing wound, or ingrown nail.
Re-operation is necessary with often ablation of the prosthesis to get rid of the infection. It may take several weeks of antibiotic treatment before a new prosthesis can be put in place.
The prosthesis may dislocate following a combination of movements weakening the scar. Anaesthesia is necessary to reduce the prosthesis. The weakened hip may then suffer multiple dislocations that may require re-operation.
Loosening: prostheses have limited lifetimes. Statistically, however, you can expect 15 to 20 years of service.
Early loosening may occur in case of overweight, intense activity, or for no special reason, requiring premature replacement of the prosthesis.
This information, provided to you before the operation, should help you fill safe about the operation.
Knowing these risks with help you prevent and reduce them
