Prior to choosing surgery patient’s ask “What are complications associated with a joint replacement surgery?” While many complications are infrequent, there are still a few to be on the look out for.
What are the common complications after Hip and Knee Replacement?
The most common single complication with joint replacement is the development of blood clots. There are two types that form. Deep vein thrombosis happens when blood clots form in the patient’s legs after surgery. Pulmonary embolisms are blood clots that may travel up from the legs to the patient’s lungs.
Blood clots form when patients are sitting or lying down for long periods of time after their surgery. This slows the movement of blood and allows it to clot in the legs. When we perform knee and hip replacement at Pinehurst Surgical, we place patients on blood thinners and are diligent about getting everyone up and moving as soon as possible.
Other complications involve the new prosthetic joint. These include:
- Infection — Infection occurs in about one-half percent of all total joint replacement procedures. This is a far more likely occurrence in patients who have diabetes or a weakened immune system. It is difficult to resolve, and often the new joint will need to be removed and then replaced after the infection has cleared.
- Dislocation of the new joint — This is a rare complication usually brought on by the patient forcing a return to activity before the new joint is fully healed and ready for use. This may require revision surgery.
- Inability of the new joint to loosen — In knee replacement, scar tissue can form to the degree that it affects the range of motion and the flexibility in the repaired joint. If there is severe stiffness, Dr. Moore may need to perform a follow-up procedure to break up the scar tissue or to otherwise adjust the prosthesis inside the knee.
- Loosening of the new joint — Deemed a complication, long-term loosening of the new joint is simply a byproduct of use and wear and tear. Eventually, if the prosthesis becomes too loose, another replacement could be required.
- Wear and tear of the new joint — Sometimes, particularly if the patient is hard on their new joint, small pieces may break off and damage the adjacent bone. This can require surgery to replace the damaged parts and possibly to address damage to the bone.
How soon after Joint Replacement could complications arise?
There isn’t a typical timeframe for complications. Blood clots can form while the patient is still in the hospital after surgery, or they can form up to about two weeks after surgery. At that point, mobility is such that the incidence drops dramatically.
Infection in the new joint is rare, but if it occurs this will generally happen within 90 days after surgery.
Other complications, such as residual stiffness of the prosthesis, can occur as the body adapts to the prosthesis and builds scar tissue around it. This can take a few weeks to become fully evident.
What are the rates of complications developing?
Analysis of data from Medicare shows that the average rate of revision surgery within 90 days of joint replacement is 0.2 percent. This rate rises to 3.7 percent within the next 18 months. Long-term wear and loosening of the implant affect 6 percent of people after 5 years and 12 percent after a decade.
Overall, the success of joint replacement heavily outweighs any risk of complications. Over 82 percent of replacement knee joints are still working 25 years after implantation. For hip replacement, studies show that over 80 percent of all hip replacements last at least 15 years, and more than 70 percent last at least 20 years.
When should you contact a doctor if you believe you are having complications?
If you have any doubts or questions about what’s going on, such as a possible complication like infection, this merits an immediate call to Dr. Moore or your primary care physician for information. Once they hear what’s going on, they can tell you if you need to come in immediately or not. Issues such as fever and symptoms of blood clots are emergencies and need immediate attention.
Complications surrounding the function of your new prosthesis may need a little time to see if physical therapy will work to expand the range of motion and other uses of your new joint.
How long is the healing process for hip and knee replacements?
For knee replacements, the American Association of Hip and Knee Surgeons say that it can take up to 3 months to return to most activities, and 6 months to a year before your knee is as strong and resilient as it can be.
For hip replacements, patients can return to most normal light levels of activity at 3 to 6 weeks. In 6 weeks, you should be able to drive again. At 10 to 12 weeks, you should be able to return to your regular day-to-day activities.