Most patients experience a patch of skin numbness, about the size of their hand just beyond the incision site of an anterior hip replacement. This patch of skin numbness will not affect your function.
Leg Length differences
Often after hip replacement, the operated leg is slightly longer than before surgery. This is often favourable because arthritic hips are often shorter than non-arthritic hips. Dr. Cayen will use either x-ray or computer navigation technology during your hip replacement surgery in an attempt to make leg lengths as even as possible during surgery. A leg length difference of more than 2cm after surgery is very rare, unless there was a significant leg length difference before surgery. Many leg length differences immediately after surgery “even out” with time as the pelvis adjusts.
Some blood loss during hip replacement is normal. Blood loss requiring a blood transfusion after surgery is rare unless you are anemic (low hemoglobin levels) before surgery or you are having both your hips replaced at once. You will be sent for blood work when you book your surgery to make sure that you are not anemic. If you are anemic before surgery, we will refer you to our Patient Blood Management Coordinator who may suggest ways to build up your hemoglobin levels prior to your surgery.
The lifetime risk of a serious infection after a hip replacement is approximately 1%. Some of these infections occur soon after surgery, but most occur months or years afterwards. The treatment for serious (deep) infections includes revision surgery and IV antibiotics.
More commonly, patients can get less serious skin infections “cellulitis”, which can often be treated with antibiotics that can be taken by mouth. Sometimes surgeons will opt to “wash out” a skin infection in the operating room if the cellulitis gets serious.
People at higher risk for infection include patients with poorly controlled diabetes, patients with morbid obesity (BMI more than 40), patients who are immunocompromised, or are taking immunosuppressant drugs, patients with peripheral vascular disease and smokers. An ongoing infection at the time of surgery from another source (eg active urinary tract infection, tooth abscess, diabetic foot infection) can increase your risk of infection after surgery.
In order to prevent infection, your surgeon will give you one dose of antibiotics through your IV in the operating room before your surgery. You will get another dose after your surgery. Growing evidence suggests that prolonged administration of antibiotics after your surgery does not prevent infection.
The symptoms of infection include fevers, redness around the wound, persistent leaking from the wound and increasing pain in a previously well-functioning joint replacement. If you think you are developing an infection around your hip replacement, call your orthopaedic surgeon’s office as soon as possible or go to your nearest emergency department.
Blood clots in leg veins can occur after hip surgery. Your surgeon will prescribe a medication for you to take after your surgery in order to prevent blood clots. If a clot develops in a deep leg vein (deep vein thrombosis – DVT) above the knee, it will need to be treated with stronger blood thinners. Above knee DVTs need to be taken seriously because they can cause clots that go to the lungs (pulmonary embolus), which is a serious condition. If you have previously had a DVT, please let your surgeon know prior to your surgery.
Pain after Hip Replacement
It is normal to have some soreness in the hip after anterior hip replacement. This soreness typically improves significantly over the first 6 weeks after surgery. Many people still experience soreness up to 3-6 months after surgery. Barring complications, hip replacement surgery can help with 85-90% of hip pain at the 3-month mark. It is important to know that although most patients enjoy improved function, improved mobility and significant pain relief after recovery, a hip replacement does not typically feel like a “normal” hip.
Although unusual, hip dislocation is when the ball of the hip replacement comes out of the socket. If this happens, you will know that something is wrong and will need to go to your nearest emergency department to have the hip put back into place. The most common reason this happens is bending forward or twisting awkwardly. Other reasons for hip dislocation include infection, component malposition and shortening of the leg after surgery. The risk of dislocation is highest in the first 3 months after surgery. Recurrent hip dislocations sometimes require revision surgery. The risk of hip dislocation after the anterior approach is theoretically lower than the risk of dislocation after the posterior approach.
The metal components of the hip replacement are meant to bind with your bone in the first 3-6 months after surgery. Over the years however, this bond can loosen, requiring a revision of the components. Less common causes of early loosening include infection or failure of the components to bond to bone after implantation.
Damage to Blood Vessels or Nerves
Damage to major blood vessels or nerves causing permanent muscle weakness is exceptionally rare, especially from the anterior approach.