Hip replacement - Risks 

Risks of hip replacement surgery 

The most common complication of hip replacement is that something goes wrong with the joint, which occurs in around 1 in 10 cases.

Joint problems

Some common types of joint malfunctions are listed below.

Loosening of the joint

The most common problem that can arise as a result of a hip replacement is loosening of the joint. This can be caused by the shaft of the prosthesis becoming loose in the hollow of the thigh bone, or due to thinning of the bone around the implant.

Loosening of the joint can occur at any time, but it normally occurs 10-15 years after the original surgery was performed.

Signs that the joint has become loose include pain and feeling that the joint is unstable.

Another operation (revision surgery) may be necessary, although this cannot be performed in all patients.

Hip dislocation

In around 3% of cases the hip joint can come out of its socket. This is most likely to occur in the first few months after surgery when the hip is still healing.

Further surgery will be required to put the joint back into place.

Wear and tear

Another common complication of hip replacement surgery is wear and tear of the artificial sockets. Particles that have worn off the artificial joint surfaces can be absorbed by surrounding tissue, causing loosening of the joint.

If wear or loosening is noticed on X-ray, your surgeon may request regular X-rays. Depending on the severity of the problem, you may be advised to have further surgery.

There have been reports about metal-on-metal implants wearing sooner than expected and causing complications. The Medicines and Healthcare products Regulatory Agency (MHRA) advises that particular metal-on-metal implants should be checked anually. You can consult your doctor for further advice if you have any concerns about your hip replacement or do not know which type you have.

Read our metal-on-metal implant advice Q&A for more information.

Joint stiffening

The soft tissues can harden around the implant, causing reduced mobility. This is not usually painful and can be prevented using medication or radiation therapy (a quick and painless procedure during which controlled doses of radiation are directed at your hip joint).

Serious complications

Serious complications of a hip replacement are uncommon, occurring in fewer than one in a 100 cases.

These are described below.

Blood clots

There is a small risk of developing a blood clot in the first few weeks after surgery.

There are two main places a blood clot can develop:

Symptoms of a DVT include:

  • pain, swelling and tenderness in one of your legs (usually your calf)
  • a heavy ache in the affected area
  • warm skin in the area of the clot

Symptoms of a pulmonary embolism include:

  • breathlessness, which may come on suddenly or gradually
  • chest pain, which may be worse when you breathe in
  • coughing

If you suspect that you have either of these types of blood clots you should seek immediate medical advice from your GP or the doctor in charge of your care. If this is not possible then call NHS 111 or your local out-of-hours service.

In order to reduce your risk of blood clots you may be given blood thinning medication such as warfarin, or asked to wear compression stockings.

Infection

There is always a small risk that some bacteria could work its way into the tissue around the artificial hip joint, triggering an infection.

Symptoms of an infection include:

  • a high temperature (fever) of 38°C (100.4°F) or above
  • shaking and chills
  • redness and swelling at the site of the surgery
  • a discharge of liquid from the site of the surgery
  • hip pain that can persist even when resting

Seek immediate medical advice, as detailed above, if you think you may have an infection.

Page last reviewed: 20/07/2014

Next review due: 20/07/2016

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

serendipity62 said on 14 September 2013

I had R THR Dec 2009 which made a good recovery and I regained full mobility except for a little occasional twinge and a problem with my right foot which I felt I was weight bearing on the outside of the foot when walking. I thought this would resolve in time and was told so. In 2011 I began to be unable to weight bear on the R for quite a few minutes on getting out of bed in morning hovwever this resolved in a few weeks and was replaced by pain in hip thigh and groin The pain was a bit non specific but began to make me limp on occasions and steadily increased . On my review in March 2012 radioluscent lines were evidenced on Xray but follow up bone scan showed no 'hot spots'. The surgeon said he didnt know the cause of my pain and it may be referred pain from my back, he will review me in March 2013.The pain has increased in the last few months, I have a slight limp, my back hurts on the right and my R foot is painful and has become a big part of the problem , and I often have 'start up' pain when getting up from a chair, its sometimes excrciating but generally extrmely uncomfortable and not what I expected as my activities have now been restricted again. . The surgeon will see me earlier than next March if I feel I need to go but I just wonder whether I shoud see how it goes for a while longer.I would aprreciate to hear of similar experiences

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cornishbird said on 20 April 2013

This is for xena............you sound as desperate as me! I had my right hip replaced in December. I never felt it had settled and 3 weeks ago I was told my abductor muscle had dettached from the bone which is why I had so much pain and couldn't walk properly. I had an operation to have it reattached and still dont feel it has helped. I'm going to see my consultant AGAIN this week but am rapidly losing any confidence in him! I have been extremely careful and followed all the experts advice. I'm beginning to think I will never walk properly again. I am 50 years old and need to return to work!

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Xena1011 said on 19 March 2013

I had my left hip replaced in Dec of 2011. In Feb 2012, as I was coming off the pain meds, the pain on the right side became excruciating. So, the surgeon decided that even though the Xray did not show that there was significant reason for right hip replacement, due to the pain, he replaced the right one in November of 2012. This made the pain even worse. Now another surgeon says there is actually a tear in the adductive groin muscle and can only explain it by suggesting that it may have occurred during the first hip replacement. Is this an ordinary risk of this surgery? If not, is there anything I can now do to reduce or rid myself of the pain? Please, somebody out there help me! I really can't imagine having this pain indefinitely. It is too terrible.

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Ian Charlton said on 05 January 2013

Why no mention of nerve damage. Had a right side THR in April 2011 and since have had constant pain and foot drop and I'm still not sure if I will ever make a full recovery. When I enquired as to how this happened I was told I was just unlucky and that it was very rare. If I could give any advice to anyone having this op it would be to ask your surgeon how many ops he has done and how many have resulted in complications, ask him what steps he takes to minimise the risks of nerve damage and if you are not happy with his answers find another surgeon. I'm in my early fifties and reasonably fit so I'm coping ok but I wouldn't like to go through this in my 60's or 70's.

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A Matthews said on 14 October 2012

In terms of risks following THP, there is a lot of information about what to look out for regarding wound infection and what movements to avoid when using your new hip. All of which is really useful.
I am wondering, however, how much information is generally given to patients about types of infection that can cause loosening of the prosthesis? It was only when I was looking up the reasons for taking antibiotics before dental treatment that I discovered urinary tract infections may cause problems of this sort. I was totally unaware of this and am now worried because I had an infection after leaving hospital but did not seek immediate medical help.
Was I unlucky in not being given this information before discharge? Or is the official view that the risk is so small that it's not worth mentioning? I'd be really interested to know

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abdul_w_khan said on 01 October 2012

i had my hip replacement done about 4 weeks ago. but my new hip doesn't look normal it doesn't make pain but the new hip look bigger than the one on normal leg. i still walk on one crutch. could you please tell me what's the reason of it look bigger and how long ll it take 4 me to get full recovery thanks

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User660854 said on 29 March 2012

I had a Total Right Hip Replacement on 10th January 2012. I ended up staying in hospital for 44 days!
My wound kept leaking and bleeding. They took me to theatre for 4 separate wash outs. Found 2 separate clots one of approx 350ml and the other approx 450ml. Then I got an infection called Staph Aureus and then another called Diptheroid. I was put on both oral and IV anti-biotics and had to have an angiogram done to try and embolise the bleeding in my hip and at the same time they inserted a Hickman Line.
The took me off the blood thinning drugs as my HB dropped to about 6 and my blood pressure to 50/30. Then during this time I had about 8 units of blood for the HB.
One night when it dropped very low, they told me they almost lost me and were giving me blood, serum and god knows what else...I was too busy having a near death experience!
During all this my actual hip felt great (if you can believe that!).
The worst thing for me was the fact that the last operation I had was a knuckle replacement and I had a similar experience (without the nearly dying bit) and it was done by the same surgeon. But prior to that I had both my knees replaced by a different surgeon and had no problems at all. This has left myself as well as family and friends with a huge question. Was it something to do with the surgeon or am I just damned unlucky to go through the same thing twice?
I know that Rheumatoid Arthritis can cause healing problems and I also appreciate that when you sign your consent form it tells you of possible risks. But I am now confused as to whether I should take this any further.
If there is anyone out there with any advice, it would be really appreciated.

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j_uk_02 said on 19 March 2012

To J M Hopkins -
What you are describing will not be a complication of a hip replacement. I am a nurse I work on an orthopaedic ward.
The symptoms you describe could describe many things. Persist with contacting the GP again explaining each symptom as urine test firstly and memory tests could be done to determine the cause of the confusion. It is likely your dad may have had multiple urinary tract infections and need some antibiotics to sort it out. Hope that helps.

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maidlynx44 said on 17 January 2012

i had my hip done in april 2011, i havent had any of those symptoms your dad is having

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j m hopkins said on 03 December 2011

my father is 78 yrs old & had hip replacement 3rd oct 2011 since the op he has lost weight cannot steady his balance is very confused,constantly passing urine,thirsty and drained his health seems to be deteriarating,taken to gp but they refer for hearing test.please tell me if these symptons are to do with his operation as he not been the same since?

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