Hip replacement surgery is one of the most common orthopaedic surgeries and has been performed in the UK since the 1940’s. Between 2003 and 2014, the NHS undertook over 700,000 hip replacement operations. This article will discuss some of the key facts behind hip replacement surgeries and their possible complications.
The most common reason for undergoing a hip replacement operation is rheumatoid arthritis, a condition that causes painful swelling and stiffness in the joints. Alternatively a hip joint can be damaged due to certain activities and life style choices. Where non-surgical treatments prove ineffective, such as physiotherapy and medication, a hip replacement procedure can lead to a relatively quick and effective solution for a patient.
There are three main types of hip replacement operations: cemented, uncemented and hybrid replacements. The merits of each procedure will vary from person to person and it is the duty of health care officials to properly advise patients on the benefits and risks of each option. Cemented replacements are more frequently used for older, less active people and people who have weak bones, such as those who suffer from osteoporosis. The artificial hip is fastened to healthy bone using special glue. Uncemented replacements are more frequently used for younger, more active people. They are made from porous material and the bone is allowed to grow into the artificial joint. Hybrid replacements use aspects of both the cemented and uncemented methods.
A hip replacement is expected to last 10 years and fortunately over 95% of hip replacement operations meet this target. However, 1 in 10 procedures will suffer from some complications. The most common complications are dislocations, where the artificial joint is not properly fastened or ill fitting. Signs of dislocation are the hip feeling painful, loose or unstable. Under these circumstances, the hip must be removed and replaced in a procedure referred to as a revision surgery.
Revision surgery is a much larger operation, requiring much more extensive dissection of soft tissue to remove components and as such carries even greater risks and a lower chance of success. In this case, even further revision surgery is necessary in over 15% of cases and the artificial joint will become less effective every time it is replaced. Other common complications include blood clots or infections at the site of surgery.
As with most operations, complications are sometimes unavoidable. However, this does not exclude the possibility that a treatment has been performed negligently. A surgeon firstly has a duty to their patient to properly advise them on their treatment options. Secondly, a surgeon must perform the operation itself to a reasonable standard. Often it may be the case that the hip has been incorrectly positioned and fails to restore a natural gait. Lastly, a patient’s implant must be sufficiently monitored post-operatively to potentially avoid months or even years of unnecessary pain and suffering. Failure to meet any of these duties will potentially be negligent and lead to a successful claim.