What to Expect After Surgery
Once your knee or hip replacement surgery is complete, there are many things you can do to ensure a successful recovery. Find out about the exercises and rehabilitation needed after surgery as well as pain medications and potential risks and complications.
Potential Complications Following Knee Replacement Surgery
As with all major surgical procedures, complications can occur. This is not intended to be a complete list of the possible complications, but these are the most common complications.
Thrombophlebitis, sometimes called Deep Venous Thrombosis (DVT), can occur after any operation, but is more likely to occur following surgery on the hip, pelvis, or knee. DVT occurs when the blood in the large veins of the leg forms blood clots within the veins. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they get lodged in the capillaries of the lung and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. (Pulmonary = lung, embolism = fragment of something traveling through the vascular system). Our surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible! Some of the commonly used preventative measures include pressure stockings to keep the blood in the legs moving and taking medications that thin the blood and prevent blood clots from forming.
Infection can be a very serious complication following an artificial joint replacement surgery. The chance of getting an infection following artificial knee replacement is probably somewhere around one percent. Some infections may show up very early - before you leave the hospital. Others may not become apparent for months, or even years, after the operation. Infection can spread into the artificial joint from other infected areas. Your surgeon may want to make sure that you take antibiotics when you have dental work or surgical procedures on your bladder and colon to reduce the risk of spreading germs to the joint.
In some cases, the ability to bend the knee does not return to normal after an artificial knee replacement. Many orthopaedic surgeons are now using a continuous passive motion (CPM) machine immediately after surgery to try and increase the range of motion following artificial knee replacement. Other orthopedic surgeons rely on physical therapy beginning immediately after the surgery to regain the motion. It is not clear which is the best approach. Both approaches have benefits and risks, and the choice is usually made by the surgeon based on his experience and preferences. To be able to use the leg effectively to rise from a chair, the knee must bend at least to 90 degrees. A desirable range of motion should be greater than 110 degrees. Balancing the ligaments and soft tissues (during surgery) is the most important determining factor in regaining an adequate range of motion following knee replacement, but sometimes increasing scarring after surgery can lead to an increasingly stiff knee. If this occurs, your surgeon may recommend taking you back to the operating room, placing you under anesthesia once again, and forcefully manipulating the knee to regain motion. Basically, this allows the surgeon to breakup and stretch the scar tissue without you feeling it. The goal is to increase the motion in the knee without injuring the joint.
The major reason that artificial joints eventually fail continues to be a process of loosening where the metal or cement meets the bone. There have been great advances in extending how long an artificial joint will last, but all will eventually loosen and require a revision. A loose prosthesis is a problem because it causes pain. Once the pain becomes unbearable, another operation will probably be required to revise the knee replacement.
As with any medical treatment, individual results may vary. Only an orthopedic surgeon can determine whether an orthopaedic implant is an appropriate course of treatment. There are potential risks, and recovery takes time. The performance of the new joint depends on weight, activity level, age and other factors. These need to be discussed with your doctor.
Checking on My Hip Replacement
Being aware of the signs of hip implant complications will help you to know when to seek medical help.
Your hip implant may have complications because:
- The hip joint is moved the wrong way
- The joint surface wears away
- The bone wears away
- The implant becomes loose
- The replacement parts break or fracture
- The cement used to fix the hip cracks or loosens
Implant complications may include one or more of the following signs:
- New or recurrent pain in the groin, hip, buttock or thigh
- Pain with walking
- Pain with rising from a sitting position
- Weakness in the leg
- Decreased movement of the hip joint
- Decreased ability to stand on the leg
- Redness and/or tenderness over the joint
- Gradual or sudden shortening of the leg
Contact your surgeon right away if you believe you are having complications with your hip implant.
Your surgeon will examine your hip and leg. You will probably be asked to have an x-ray or scan of the joint. Your surgeon will decide what is causing the complications and talk to you about treatment options