Complications and Risks after Hip Replacement

Understanding risks and complications in detail after a hip replacement surgery will help patients in making better informed decisions, take preventive measures and feel more confident during their surgical journey.

Complications and Risks after Hip Replacement

While modern medical advancements have made this procedure relatively safe with high success rates, it’s essential for patients and their families to be well-informed. Knowing what to expect can help in preparing for the surgery, recovery, and ensuring the best possible outcome.

Hip Replacement
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Understanding Risks and Complications

Many individuals who undergo this procedure report dramatic reductions in pain and significant improvements in their quality of life. However, as with any surgical procedure, there are potential risks and complications associated with hip replacement.

Now, we’ll mention the key points in detail of those potential risks and complications associated with hip replacement surgery.

CategoryRisks and ComplicationsDescription
Surgical RisksBlood ClotsFormation of a blood clot which can obstruct a blood vessel.
Nerve DamageInjury to nearby nerves during the operation.
FractureBreakage of a bone during or after the operation.
Change in Leg LengthAlteration in the length of the operated leg compared to the other.
DislocationMisplacement of the new joint from its proper position.
Short-Term Post-Operative ComplicationsInfectionInfection at the surgical site or in the implant.
Swelling and BruisingAccumulation of fluid or blood in the operated area.
Unexpected PainPain that wasn’t anticipated or is more intense than expected after the operation.
Tingling Sensation or NumbnessTingling as “pins and needles,” numbness as lack of sensation; both temporary in the operated leg.
Long-Term Post-Operative ComplicationsLoosening of the ImplantMovement of the implant from its initial position over time.
Wear of the ImplantWear and tear of the implant material due to continuous use.
Muscle WeaknessLoss of strength in muscles surrounding the operated joint.
StiffnessReduced range of motion of the operated joint.
Allergic and Immune ResponsesAllergic ReactionsBody’s response to implant materials or medicines.
Issues with AnaesthesiaSide effects or adverse reactions to the anaesthetic used.

A comprehensive overview of the potential challenges associated with hip replacement surgery is crucial to remember and be inform all along your orthopaedic healing journey.

By understanding these risks, you are better equipped to collaborate with your medical team, ask pertinent questions, and take proactive measures for a smooth surgery and recovery.

The success of your hip replacement doesn´t just lie in the surgeons hands but also in your understanding and preparation for the procedure

Hip Replacement Surgical Risks

Surgical Risks are the immediate concerns that arise during the surgery or shortly after. While these are relatively rare, they underscore the need for skilled surgical teams and comprehensive pre-operative assessments.

Blood Clots

Blood clots, particularly deep vein thrombosis (DVT), are concerning not just because they can form after a surgery but also due to their potential to travel to the lungs, leading to a life-threatening condition known as pulmonary embolism.

  • Occurrence & Affected Individuals: Blood clots tend to manifest within the first week after surgery. Individuals with a familial history of clotting disorders, certain lifestyle factors like smoking, or those with prolonged bed rest can be particularly susceptible.
  • Prevention, Detection & Management: The key to management lies in prevention. This might involve the prescription of anticoagulant medications, encouraging movement post-surgery, and using devices like compression stockings. Early detection through symptoms or ultrasounds can pave the way for prompt treatment, typically involving medications to dissolve the clot.

Studies show that patients who are well-prepared for surgery experience 30% less anxiety and report higher satisfaction rates post operation

Nerve Damage

The hip region is a nexus of crucial nerve pathways. Damage can lead to a spectrum of symptoms, from the benign numbness to debilitating pain or even muscle weakness.

  • Occurrence & Affected Individuals: The event of nerve damage, although rare, happens intraoperatively. Those with pre-existing neuropathic conditions might be more vulnerable.
  • Prevention, Detection & Management: Mastery in surgical technique and meticulous pre-operative planning are primary preventive measures. Post-operatively, neurologists might employ nerve conduction studies or EMGs to ascertain the extent and nature of damage. Management is multifaceted, ranging from physiotherapy to medications, and in severe cases, surgical intervention.


The very thought of a bone fracturing during an operation is unsettling. But the reality is that bones, especially osteoporotic ones, can sometimes be fragile.

  • Occurrence & Affected Individuals: This complication arises intraoperatively. Patients with osteoporosis or those on certain medications that thin the bone are at an elevated risk.
  • Prevention, Detection & Management: Surgeons often adapt their techniques, employ specialised instruments, or choose specific implants to minimise this risk. Radiological evaluations like X-rays can identify fractures post-operatively. Treatment might necessitate a period of immobilisation or, in rare cases, further surgical procedures.

Change in Leg Length

Post-surgery, as patients take their first steps, they might notice an unsettling asymmetry in their leg lengths.

  • Occurrence & Affected Individuals: This becomes apparent as the patient starts ambulating post-surgery.
  • Prevention, Detection & Management: Rigorous pre-operative templating and meticulous intra-operative measurements help in ensuring leg length equality. Should a significant discrepancy arise, solutions range from shoe modifications to physiotherapeutic interventions. In very rare cases, a surgical revision might be considered.


The unsettling event of the new hip joint “popping out” of place can be a traumatic experience for patients.

  • Occurrence & Affected Individuals: This risk is most pronounced in the initial post-operative weeks. Those who do not adhere to movement restrictions or have a history of multiple hip surgeries might be more prone.
  • Prevention, Detection & Management: Patient education is pivotal. By understanding and respecting movement restrictions, using aids like abduction pillows, and occasionally donning a hip brace, patients can significantly reduce their risk. If a dislocation does occur, a closed reduction (manually putting the hip back in place) is often the first line of treatment. Persistent dislocations might necessitate surgical interventions.

Short-Term Post-Operative Complications

Short-Term Post-Operative Complications are the challenges that patients might face in the days and weeks following the surgery. These complications might relate to the body’s immediate reaction to the procedure, such as infections or unexpected pain. 


Infections are the invaders post-surgery that can range from being superficial to deep-seated, even involving the artificial joint.

  • Occurrence & Affected Individuals: Infections might surface within days to weeks post-surgery. Individuals with conditions like diabetes, those on immunosuppressive medications, or those with a history of recurrent infections are at higher risk.
  • Prevention, Detection & Management: Sterile surgical techniques, prophylactic antibiotics, and diligent wound care are paramount. Symptoms like increasing redness, warmth, or discharge from the surgical site should warrant immediate medical attention. Treatment may involve oral or intravenous antibiotics, and in severe cases, additional surgical intervention.

According to the Centers for Disease Control and Prevention (CDC), surgical site infections are the most-common healthcare-associated infections in surgical patients, with up 4% experiencing an infection within 30 days after a surgical procedure.

Swelling and Bruising

It’s the body’s way of reacting to trauma, in this case, the surgical procedure.

  • Occurrence & Affected Individuals: Almost everyone will experience some degree of swelling and bruising post-operatively, peaking around 48 hours after the procedure.
  • Prevention, Detection & Management: Elevation of the operated limb, cold compresses, and prescribed anti-inflammatory medications can help manage this. Persistent or extreme swelling should be reported as it might indicate other complications.

Unexpected Pain

Pain is subjective and can sometimes surpass anticipations.

  • Occurrence & Affected Individuals: While most patients will experience post-surgical pain, some might find it more intense or enduring than anticipated.
  • Prevention, Detection & Management: Adequate pain management protocols, involving a combination of systemic medications and local interventions, can help. Open communication about pain levels allows healthcare providers to tailor management strategies.

Numbness and Tingling Sensation

The odd sensation akin to “pins and needles.”.

  • Occurrence & Affected Individuals: This sensation might emerge post-operatively, especially if nerves were manipulated or stressed during the procedure.
  • Prevention, Detection & Management: Mostly transient, these sensations often resolve on their own. Physical therapy and certain medications might be employed if they persist. Monitoring for any worsening or persistence of numbness is crucial, as it might indicate more significant nerve involvement.
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Long-Term Post-Operative Complications

Long-Term Post-Operative Complications are concerns that could emerge months or even years after the surgery. Over time, for example, the implant may wear down or become loose. Or muscles around the joint might weaken, affecting mobility. Such complications highlight the importance of ongoing post-operative care and monitoring. 

Loosening of the Implant

An unsettling scenario where the once-firm implant no longer sits snugly.

  • Occurrence & Affected Individuals: This might manifest months to years’ post-operation. Individuals with high physical activity levels or those who engage in high-impact activities might be more at risk.
  • Prevention, Detection & Management: Regular follow-ups with X-rays can detect early signs. Minimising high-impact activities and adhering to physiotherapy protocols can reduce risk. Surgical revision might be needed in some cases.

Wear of the Implant

The relentless march of time can wear down even the sturdiest of implants.

  • Occurrence & Affected Individuals: Manifests years after the procedure, especially in very active individuals.
  • Prevention, Detection & Management: Using implants of high-quality materials and regular monitoring can delay this. If wear affects function or causes pain, a surgical revision might be contemplated.

Muscle Weakness

The supporting cast of muscles around the joint might falter over time.

  • Occurrence & Affected Individuals: This can crop up months to years’ post-surgery, especially if regular physiotherapy and exercises aren’t maintained.
  • Prevention, Detection & Management: Regular physiotherapy and strength training exercises are critical. Muscle relaxants or additional physical therapy might be needed if weakness is pronounced.


Reduced range of motion can tether an individual’s activities.

  • Occurrence & Affected Individuals: Without regular movement and exercises, stiffness can set in weeks to months post-operation.
  • Prevention, Detection & Management: Regular stretching, physiotherapy, and sometimes joint manipulation can counteract this. Medications to reduce inflammation might also be prescribed.

According to Academy of Orthopaedic Surgeons (AAOS), regular follow-up appointments can catch potential issues before they become real problems, ensuring the longevity of your hip implant.

Allergic and Immune Responses

Allergic and Immune Responses remind us that every individual’s body is unique. Some might have allergic reactions to the implant materials, or the medicines used. Others might face complications from the anaesthesia.

Allergic Reactions

Our body’s defence system sometimes sees the implant or medication as an invader.

  • Occurrence & Affected Individuals: Allergies can surface days to weeks post-operation. Those with a history of allergies, especially to metals, are at a heightened risk.
  • Prevention, Detection & Management: Pre-operative allergy testing can be invaluable. If an allergic response is detected post-operatively, treatments range from medications to, in rare cases, replacement of the implant.

Issues with Anaesthesia

The agents that ensure pain-free surgery can sometimes have repercussions.

  • Occurrence & Affected Individuals: Complications might arise during the surgery or in the immediate post-operative period. Individuals with a history of anaesthesia complications, certain medical conditions, or those on specific medications might be more susceptible.
  • Prevention, Detection & Management: A thorough pre-operative assessment by an anaesthetist can pinpoint potential issues. Monitoring during and after surgery ensures any complications are swiftly addressed. Treatments range from medications to support therapies, depending on the nature of the complication.

Post-Operative Care Tips

Post-operative proper care determines a swift recovery, longevity of the implant, and reduction in potential complications leading to hip replacement surgery success.

Essential Post-Operative Care Tips for a Successful Recovery

  • Wound Care: Keep the surgical site clean and dry to prevent infections, a common post-op complication.
  • Physiotherapy: Consistently attend physiotherapy sessions to accelerate recovery and regain mobility.
  • Medication Adherence: Strictly follow the prescribed medication regimen to manage pain and prevent blood clots.
  • Activity Levels: Adhere to medical advice on weight-bearing and the use of walking aids to ensure proper healing.
  • Signs of Complications: Be vigilant for signs like increased redness, warmth, or discharge, as these could indicate an infection.
  • Regular Check-ups: Never skip follow-up appointments; early detection of issues can prevent long-term complications.
  • Open Communication: Maintain a transparent dialogue with your healthcare team to adapt your recovery plan as needed.
  • Mental Well-being: Don’t underestimate the power of a positive mindset; it can significantly impact your recovery speed.

These checkpoints serve as a pillar that supports your overall well-being and ensures a the longevity of your hip implant, setting the stage for long-term success.

Learn more: Recovery and Rehabilitation after Hip Replacement

Lifespan of the Hip Implant

The modern hip implant is a marvel of biomedical engineering, designed to last many years. Typically, with appropriate care and barring any complications, a hip implant can last between 15 to 20 years. However, the exact lifespan depends on multiple factors:

  • Material Quality: Using state-of-the-art materials can enhance the implant’s wear resistance.
  • Patient Activity Levels: A more active lifestyle can accelerate wear, whereas a sedentary one can led to muscle weakness or joint stiffness.
  • Adherence to Post-Op Care: Regular follow-ups, timely interventions, and physiotherapy can significantly prolong the implant’s life.

Likelihood of Needing a Revision Surgery

No implant lasts forever. Over time, due to various factors like wear and tear, loosening, or even an unexpected trauma, a revision surgery might be required.

  • Wear and Tear: Over time, the implant might wear down, especially in very active individuals or those with specific health conditions.
  • Loosening: The implant can sometimes become loose, causing pain or decreased mobility.
  • Infection: Persistent infections can necessitate a revision to remove or replace the implant.

According to the National Health Service (NHS), about 10% of hip replacements may require a revision within 15 to 20 years.

Signs That a Revision Might Be Needed

Being vigilant about the following signs can ensure timely intervention.

Critical Signs Indicating a Possible Need for Revision Surgery

  • Persistent Pain: Any new or increasing pain after the initial post-operative period could indicate implant issues.
  • Decreased Mobility: A sudden decrease in range of motion could signal implant wear or loosening.
  • Swelling: New or increasing swelling could be a sign of infection or implant failure.
  • Audible Sounds: Clicking or popping sounds from the joint may indicate implant wear or misalignment.
  • Altered Gait: A change in your walking pattern could signify issues with implant positioning or leg length.
  • Leg Length Discrepancy: If you notice a difference in leg lengths, consult your orthopaedic team immediately.
  • Regular Monitoring: Even if you feel fine, regular check-ups can catch potential issues before they escalate.
  • Consult for Unusual Symptoms: Any new or unusual symptoms should be immediately reported; it’s better to be safe than sorry.

Being vigilant about these signs is crucial for your long-term orthopaedic health. Each point on this list is a potential red flag, so the sooner you catch these issues, the easier they are to manage or correct.

Hip replacement surgery can significantly improve your quality of life. However, like any surgical intervention, it comes with its set of risks and complications. Remember, being informed is your first line of defence into this journey to a pain-free life.

Hip Replacement
Regain your mobility with Direct Anterior Approach.

Experience of Complications of Hip Arthroplasty – National Library of Medicine (NIH) I

Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia – National Library of Medicine (NIH) I

Joint infection after hip replacement is linked to some risk factors that could be modified – National Institute for Health and Care Research (NIHR) I

National Health Service (NHS) I

Health Service Executive (HSE) I

Risks of hip and knee replacement – Mount Sinai Health System I

Hip Replacement Complications – Drugwatch I

Risks of hip and knee replacement- Medline Plus I

Total Hip Replacement Surgery Risks and Complications – VERITAS Health I

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