Problems after hip replacement

A hip replacement will usually give many years of trouble free function. From large studies we know that 1/3 of patients will forget they have an artificial hip joint, the majority of the remainder are conscious of the artificial nature of the joint, but without significant pain or discomfort.

A small percentage of patients suffer ongoing pain or other complications as a result of hip replacement.

Diagnosis in these situations can be challenging and in some cases, after excluding common serious complications, it is not possible to pinpoint a cause for pain/discomfort.

Over time there is an increasing risk of any artificial joint failing. This may occur due to wear at the articulating surface, loosening of the fixation into bone or fracture of the supporting bones.

When it comes to revision (re-doing) of a hip replacement, the outcome is much better if the operation is done before bone or muscle tissue is lost.

The British Orthopaedic Association recommends regular check-ups for patients with artificial hips [BOA Primary Total Hip Replacement: A Guide to Good Practice].

Post-operative complications of total hip replacement

Muscular pains - weakness or stretching of the muscles
Tendonitis - pain using the affected muscle
Leg length inequality - some times real and sometimes due to pelvic tilt
Dislocation - usually results in attendance at hospital
Impingement - squeaking and/or pain at the extreme of movements
Clicking - snapping tendons, subluxations, disassembly
Heterotopic calcification - aching and swelling
Articular wear - microscopic particles of plastic, metal or ceramic causing local tissue responses
Loosening - start up pain in the morning
Fracture - failure of weakened bone around the implant
Infection - difficult to exclude