After Total Joint Surgery

It is important to understand that there are risks associated with any major surgical procedure and total joint replacement is no exception. Although the occurrence of these complications is low in number, each patient needs to be informed of these possible risks prior to surgery. In all cases discussion between the patient and the treating physician is imperative to put possible complications into proper perspective for a specific patient.

Possible Complications

A major potential risk with total joint replacement is the risk of infection. When a patient undergoes total joint replacement, they are started on intravenous antibiotic therapy to reduce the chance of infection. In our experience, and across the country, the risk of infection is approximately 2% or less. This means that 1 case in 200 has the potential for infection. Infection in the post operative course in most patients is treatable. It may simply require longer hospitalization, treatment with antibiotics for a longer period than normal, opening the joint and draining it, or in some instances removing the artificial components in order to cure the infection before implanting another artificial joint. In extreme cases where infection cannot be treated successfully, a patient may need to have the artificial joint removed permanently and have the joint fused.

Loosening of a prosthesis is another potential risk in total joint surgery. Loosening may occur in any one individual component or occur in all the components. The occurrence of loosening in a total joint replacement is approximately 1% per year in our experience. Loosening of a prosthesis is not usually a sudden occurrence, but a gradual process, characterized by increasing discomfort. In most instances, if a prosthesis becomes loosened, it can be corrected by another surgical procedure.

The occurrence of a blood clot or thrombosis after total joint replacement is another potential risk. Because patients are mobile very early in the postoperative period, this is a complication that is seen much less frequently now than in the past. In addition to early mobility, patients are treated with pulsatile stockings, (to prevent the stasis of blood in the lower extremities) and low doses of aspirin or other anticoagulation medications to reduce the risk of forming a thrombosis. If a patient is diagnosed with a blood clot, treatment with intravenous heparin and oral coumadin is initiated. As a result, patients may need to be hospitalized slightly longer, but recuperation remains normal overall.

While these complications may occur after any total joint surgery, both hip and knee joint replacement have unique problems which may occur.