Risks and Complications

Risks and Complications

Any operation carries risks as well as benefits. This page details the potential risks and complications associated with the common orthopaedic operations that I perform. Other specific procedures are discussed in detail under separate listings of each procedure of the hip and knee.

COMMON HIP PROCEDURES 

Hip Replacement Surgery

The majority of patients undergoing hip replacement surgery will encounter no significant complications. There will be an opportunity to discuss the risks, benefits and outcomes of hip replacement surgery when you come to clinic before your operation.  19 out of 20 patients are delighted with the outcome. 1 in 20 may experience dissatisfaction due to a variety of potential complications:

Infection:   To reduce infection risk, surgery is performed in a specially ventilated 'clean air' operating theatre and most patients are given a short course of antibiotics at the time of surgery.  Despite these measures, deep infection can occur and, in 1:100 cases, this may necessitate removal of the artificial joint and antibiotic treatment until infection has cleared. 

Blood clot (DVT):  Occasionally a blood clot can form in the deep veins of the leg causing pain or swelling in the calf. In a minority of cases, this can break away and travel to the heart or lungs and become a risk to life.  The overall risk of fatal lung clot is 1:600.  To reduce this risk you will be given calf pumps to increase the blood flow and an anticoagulant drug to inject into your stomach for twenty eight days following surgery, in keeping with current recommendations from the National Institute for Clinical Excellence (NICE).

Leg length:  Care will be taken at the time of surgery to avoid shortening or lengthening of the leg. If Mr Hoad-Reddick feels your hip is unstable during the operation, he may choose to lengthen your leg marginally to stabilize the hip; this is rarely required.

Residual pain:  In the majority of cases, hip replacement significantly improves pain and mobility; residual pain can occur and in most cases will resolve in time.

Neurovasuclar injury: ​Very rare occurence of damage to vessels or nerves in the region of surgery.

Dislocation:  An artificial hip is at risk of dislocation in the early postoperative period and physiotherapy advice will be given to avoid the hip 'at risk' positions.  Dislocation (when the hip comes out of the joint) would result in a return to the operating theatre to put the hip back in place. This risk is significantly reduced by adhering closely to the strict post-operative guidelines and compliance with physiotherapy.

Fracture: This can occur in rare cases when the stem of the implant splits the femur / thigh bone when it is inserted. If this occurs, a wire will be placed around the femur to hold the bone together around the implant. 

Implant failure requiring revision surgery:  Recurrent dislocation, fracture or wear of the implants over time can necessitate revision surgery.

If you are contemplating surgery, you will be given a leaflet 'What you need to know about your joint replacement surgery' in clinic. Patients will be in hospital for 3-4 days, on crutches for 3-4 weeks and make a functional return to normality within approximately 3 to 4 months.

Hip Arthroscopy Surgery

As with any operation, hip arthroscopy carries risks as well as benefits; the majority of patients undergoing such surgery will encounter no significant complications. Generally speaking 85% of patients are very pleased with the results of hip arthroscopy but 10% of patients see no significant improvement. 5% can have deterioration in symptoms following  surgery. A more detailed explanation of the potential risks associated with surgery is below.

Infection:   To reduce infection risk, surgery is performed in a specially ventilated 'clean air' operating theatre and most patients are given a short course of antibiotics at the time of surgery.  Despite these measures deep infection can occur in 1:1000 cases necessitating removal of the artificial joint until infection has cleared. This would also be treated with antibiotics. 

Blood clot (DVT):  Occasionally a blood clot can form in the deep veins of the leg causing pain or swelling in the calf; there is a 1:1000 chance of this. In a minority of cases this can break away and travel to the heart or lungs and become a risk to life.  The overall risk of fatal lung clot is 1:600.  To reduce this risk you will be given calf pumps to increase the blood flow and an anticoagulant drug to inject into your stomach for twenty eight days following surgery, in keeping with current recommendations from the National Institute for Clinical Excellence (NICE).

Neurovasuclar injury: ​Surgery can cause the very rare occurance of damage to vessels or nerves in the region of surgery leading to weakness, numbness and bleeding. The traction used in hip arthroscopy can cause bruising in the thigh and groin area and may pull nerves leading in numbness in the groin, pelvis or foot. These complications usually reduce within 2-3 weeks and are much less common with the use of modern traction equipment.      

Fracture: This can occur in rare cases when the stem impacts into the femur. If this occurs a wire will be put round the femur. 

This operation is performed under general anaesthetic with an overnight stay. Post-operatively patients will be on crutches for 2 and occasionally for up to 4-6 weeks if labral repair is required. For hip arthroscopy surgery there is a long course of physiotherapy postoperatively and strict adherence to this increase the chance of a successful result.

COMMON KNEE PROCEDURES

Knee Replacement Surgery

The majority of patients undergoing knee replacement surgery will encounter no significant complications. There will be an opportunity to discuss the risks, benefits and outcomes of knee replacement surgery when you come to clinic before your operation.  19 out of 20 patients are delighted with the outcome. 1 in 20 may experience dissatisfaction due to a variety of potential complications:

Infection:   To reduce infection risk, surgery is performed in a specially ventilated 'clean air' operating theatre and most patients are given a short course of antibiotics at the time of surgery.  Despite these measures, deep infection can occur and, in 1:100 cases, this may necessitate removal of the artificial joint and antibiotic treatment until infection has cleared. 

Blood clot (DVT):  Occasionally a blood clot can form in the deep veins of the leg causing pain or swelling in the calf. In a minority of cases, this can break away and travel to the heart or lungs and become a risk to life.  The overall risk of fatal lung clot is 1:600.  To reduce this risk you will be given calf pumps to increase the blood flow and an anticoagulant drug to inject into your stomach for twenty eight days following surgery, in keeping with current recommendations from the National Institute for Clinical Excellence (NICE).

Residual pain:  In the majority of cases, knee replacement significantly improves pain and mobility; residual pain and stiffness can occur and, in most cases, will resolve in time.

Neurovasuclar injury: ​This is a very rare occurrence when there is damage to vessels or nerves in the region of surgery.

Dislocation:  When a mobile plastic bearing is used, there is a small risk of dislocation of the knee. This would require further surgery.

Fracture: This is extremely rare and may require further surgery. This is more likely if patients have reduced bone density / osteoporosis.

Implant failure requiring revision surgery: Fracture or wear of the implants over time can infrequently necessitate revision surgery.

Knee Arthroscopy Surgery

As with any operation, knee arthroscopy carries risks as well as benefits; the majority of patients however undergoing this type of surgery will encounter no complication.

Infection:  Infection is rare, carrying the risk of 1:1000.  This would be treated with antibiotics.  To reduce infection risk, surgery is performed in a specially ventilated 'clean air' operating theatre. If your surgical wound is wet, oozing, overly red or swollen, or it smells unpleasant, then please contact Stafford suite as soon as possible on 0161 495 7022.

Blood clots (DVT):  Occasionally a blood clot can form in the deep veins of the leg causing pain and swelling in the calf, in a minority of cases, this can break away and travel to the heart or lungs and become a risk to life.  The risk of DVT with knee arthroscopy is in the region of 3%.

Residual pain:  Related to underlying degenerative change (wear and tear).

Bleeding into the joint:  An abnormal collection of blood in the knee joint (hemarthrosis) is rare.

Scarring:  Small skin scars on either side of the knee.

Occasionally a micro fracture technique may be performed whereby small holes (or micro fractures) are deliberately made in the bone in an attempt to stimulate new cartilage growth. Crutches will be necessary to mobilize following surgery and there is a very specific post-micro fracture rehabilitation program that we strongly recommend for all patients undergoing this procedure. This is supported by the physiotherapy team here at BMI The Alexandra hospital.  

 

 

General Enquiries

If you have any questions or queries do not hesitate to get in touch. Our office staff are friendly and helpful. Office hours are typically 8:00am till 4:00pm but if you leave us a message we will get back to you as soon as possible.

Office Phone: 0161 722 0007

Office Fax: 0161 722 0002

Email: secretary@hrorthopaedics.co.uk

We also have an active twitter page, @hrorthopaedics1 , where you can keep up to date with news about the practice and share your experiences with Mr Hoad-Reddick. You can also follow up on Facebook by searching HROrthopaedics.