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Background to Hip Replacement Surgery:
Although a common procedure, for most patients it is still filled with anxiety. here is an explanation of some of the complications that can arise from the surgery.

Like with any operation there are significant risks associated with a hip replacement operation.

Change in the length of the leg: Some increase in the length of the leg on the side of the hip replacement can occur after the surgery. Usually the increase is small and does not require to be treated. Occasionally, the leg may become longer than the other side by about half to three quarters of an inch. If the patient is aware of the difference and finds it troublesome, then a small raise in the shoe of the unoperated side is all that is necessary.

Thrombosis: This is a technical term for a blood clot. Orthopaedic surgery in general, and hip replacement in particular, carries a recognised risk of creating a blood clot in the veins of the leg. Sometimes, the blood clot may form inside the veins of the pelvis. While the clot is not dangerous in itself, it can break off and travel with the blood stream to lodge itself in another blood vessel in the lungs or in another organ. In this circumstance it may stop the blood flow to that organ and both damage it and cause serious adverse effects.

The risk of such a complication is less than one in a thousand with the precautions that we take. The surgical stockings given to patients for use before and after surgery reduce the chances of developing a blood clot. Research has also shown that encouraging patients to start walking early on after their operation also helps to avoid a blood clot as does the use of blood thinners after surgery. Best practice is to have the physiotherapists help the patients start walking on the day after their surgery and to routinely use blood thinning injections during the entire time that patients are in hospital.

Dislocation: The term 'dislocation' means the slippage of the ball of the hip joint, out of the socket. The risk of dislocation is generally less than one in a hundred.

While the chance of the hip dislocating after replacement surgery is permanent, it is highest in the period just after the operation and in the 6 weeks thereafter. It is to avoid this complication that patients are advised not to bend their hip more than a right angle. This may occur if they were to sit in a low chair or bend to the floor or reach for their toes. Also, crossing the legs or twisting the hip could cause a dislocation and should be avoided.

Infection: This is one of the more serious complications but is fortunately rare. The precise rate of infection across the U.K. (for example) is not known but is likely to be about 2%. In order to reduce the risk of infection, patients are given antibiotics routinely into the vein just prior to the surgery and two doses after. Scientific studies have shown that antibiotics given in this manner play a significant role in avoiding infection. Here is some information on infections.

Nerve injury: On rare occassions, the hip replacement surgery can produce an injury to the main nerve of the leg which is called the sciatic nerve. The risk of such an injury is about 2 or 3 out of a thousand (0.2%). The patient may notice that he or she is unable to pull the ankle and foot upwards or downwards and that the feeling in the skin in the calf or shin area does not feel normal. He or she may also be aware of patches of numbness or pins and needles. In the unfortunate event of the injury occurring, it usually involves only a portion of the sciatic nerve and is reversible. In other words, a substantial recovery occurs with time in the majority of patients.

Fracture of the thigh bone: The word 'fracture' is a technical term for a break in the bone. A fracture of the thigh bone is a rare risk during the operation.

Loosening of the artificial hip: The most common problem with an artificial hip is that it does not last for ever. After some time it does not remain fixed to the bones of the skeleton as securely as it was in the period immediately after the surgery. This explains the term 'loosening'. The problem is more prevalent on the socket side than on the thigh bone side. It is however, uncommon for loosening to occur before 10 years from the date of the surgery. In particular, more recent advances in technology and technique of surgery suggest that future results may be better compared with previous ones, but the medical profession will know this for sure only with the passage of time.

From the patients perspective, loosening of the hip can result in pain. Often this pain is felt in the groin and is worsened by walking. If the components of the hip are definitely loose on X-Rays then it is likely that your specialist will recommend a 'redo' or a revision operation. This is to control the pain and to prevent damage to the bone from the loose hip. At times the hip may loosen without the patient experiencing any symptoms and that is why patients are advised to stay under permanent review and to have X-Rays to check their hips. Occasionally, a specialist may have to advise a revision operation based upon the X-rays alone even though the patient may not be experiencing any symptoms.

Globe Health Tours can facilitate a surgery visit for you at a number of hospitals in India and Thailand:

• Kerala Lakeshore Package. click for hip replacement surgery package at Lakeshore Hospital in Kerala, South India
• click for details for hip replacement in Delhi, North India
• Thailand Package. click for details of hip replacement in Bangkok, Thailand

We have teams in India who manage your stay and provide you with support whenever you need it. Please contact us to find out how we can help you.