Hip replacement surgery is one of the most common and most successful orthopedic surgeries performed today. Over 600,000 hip replacement surgeries are performed annually in the United States. Since the majority of people who undergo this surgery are suffering from hip pain that was caused by hip arthritis, the absence or minimization of pain after surgery leaves most people very happy. However, as with all surgeries, the mechanical pieces of a hip replacement will eventually wear out. There can be any number of reasons that a hip replacement may fail over time which is why approximately 32 thousand hip replacement revision surgeries are performed every year. This does not mean that something went wrong during the surgery, or that problems will occur right away. It also does not mean that you have no recourses to alleviate your pain. If you suffer from chronic hip pain and you are a good candidate for surgery, your best chance of returning to a normal and pain-free life is to have a hip replacement. However, if you suspect that your hip replacement has failed, being evaluated by a board-certified orthopedic surgeon will be the best way to determine your next course of treatment to get you moving again with little or no pain.
Causes of a Failed Hip Replacement
The phrase “failed hip replacement” means that the surgically implanted artificial hip is no longer meeting its intended function or expectations. In fact, it is often causing pain or problems with mobility, similar to symptoms of arthritis in general. There are many things that can cause this manmade joint to fail—some avoidable and some not. Regardless of the cause, revision of the joint or another replacement may be necessary to alleviate symptoms and get you moving freely again.
In rare cases, the actual joint that has been implanted has a defect. However, problems usually occur over time from wear-and-tear after the new joint is already in place. Another rare occurrence is improper placement of the mechanical pieces during the original surgery. The greatest risk after surgery, however, is infection. While the rate of infection after a total hip replacement is less than 1% of the hundreds of thousands performed each year, watching for signs of infection after surgery is important. The damage caused by infection may lead to the need for the joint’s removal and replacement. In addition to infection, an unanticipated allergic reaction to one of the materials in the artificial joint can lead to inflammation and damage, but this is extremely rare.
Since the 1960s when hip replacement surgery was first developed, there have been many improvements made to the artificial joints that are implanted. Today’s implants have fewer complications and often last around 20 years. However, those who had hip replacement surgery years ago have older implants, and even with improvements, problems can still occur. The new implant can become loose either at the top of the thigh bone or at the socket which is attached to the pelvis. Over time the hardware can also wear down. Another material that sometimes degrades with time is the lining that protects the joint as it moves in place.
Some failure of the replaced joint can also be related to your body or your lifestyle. Falls, especially after surgery, are dangerous. Your own personal level of activity can accelerate wear and tear on the joint. At the opposite end of the spectrum, soft tissue and weak muscles may cause instability of the joint, where the ball can dislocate or come out of the socket. Age, diet, and lack of regular weight-bearing exercise can contribute to osteoporosis, or bone thinning, which can make the bone around the hip joint vulnerable. Finally, just as in the development of the osteoarthritis that often leads to the need for a hip replacement, weight gain and obesity add stress to the implanted joint which increases the risk of complications.
Symptoms of a Failed Hip Replacement
The cause of the failure of your hip replacement may create variations in symptoms but there are common things that you should watch for post-operatively and in years to come. Some hips fail right after surgery, but it cannot be stressed enough that the regular and continued follow up that your orthopedic surgeon recommends is essential to monitor the health of your hip replacement and to identify problems early if they arise. Sometimes the only way that a failed hip replacement is found is by an exam by your orthopedic surgeon and x-rays, even in the absence of any other symptoms.
Symptoms that should alert you that you may have a problem include fever and pain right after surgery. Poor or slow progression in physical rehabilitation can also indicate problems. Even after your initial recovery from hip replacement surgery, you should be aware of any changes in the way your hip feels or functions, or any new noises from the replacement. Hip pain, groin pain, or thigh pain are all signs that your hip replacement could have an issue, although other referred pains can cause these symptoms too. Pain when you first get up to walk can also be a concern. Some people report instability or feeling like their hip is going to give out. If you are having trouble walking, standing in place, maintaining your balance, or simply feel unsafe on your feet, it is time to see your orthopedic surgeon.
What’s Your Next Step?
Most surgeons recommend that anyone who has had a hip replacement should follow up once a year for an x-ray as preventative maintenance. As stated, this is extremely important because what you may not notice yet, your orthopedic surgeon may be able to identify. However, if you have experienced any of the above-mentioned symptoms including those of infection, or if you have had a significant trauma or fall, it is very important that you contact your orthopedic surgeon so that you can be evaluated. You may need radiographic or blood tests. Your treatment will vary depending on the source of the problem, including the possibility of surgical correction. If you are having significant pain, ask your doctor if you can take any medications before seeing them. Some over the counter medications may interfere with any possible upcoming surgical procedure. It is also very important to think about your safety. If your hip hurts, or if you are having strength or mobility issues, you may not be steady on your feet. A fall will only make things worse. Pull out your walker and use it consistently until you can see your orthopedic surgeon.
Hip replacement surgeries are one of the most common and successful orthopedic surgeries performed today. These procedures have improved the quality of millions of lives. If you have any questions about hip replacement surgery, or if you are bothered by hip pain, we are here to answer your questions and help you get moving again. To seek the expert advice of Dr. Brett Gilbert in Raleigh, Durham, Apex, or Cary, contact us today by calling us at (919) 788-8797 or you can request an appointment with Dr. Gilbert using our appointment request form, or you can self-schedule your appointment here.