Complications associated with joint replacement surgery

Patient consultation iStock.com/annebaek

Joint replacement is one of the most common operations carried out, even in elderly people. The benefits of this surgery usually prevail but, like all other operations, it also carries risks. However, prevention, a minimally invasive surgical technique and diligent follow-up care mean that, as a rule, complications can be avoided.

The general complications that can occur with any surgery include:

Thrombosis/embolism, damage to nerves or bone, secondary bleeding and bruising around the wound, or impaired wound healing

After joint replacement surgery, the following specific complications may also occur in some cases, and these may possibly lead to revision surgery:

As a manufacturer of bone cements, Heraeus Medical is aware of very rare cases of allergic reactions in patients. In a few cases, the reactions can be attributed to the metal alloys used in the implants, but they can also be due to a component of the bone cement.

However, some patients tolerate the inserted metal implants even though they are actually allergic to metals.

Testing of the cured bone cements by Heraeus Medical has shown that, in principle, they do not have any sensitising potential in principle.

Temporary fluctuations in the blood pressure and pulse may occur during surgery in association with the cementing of an endoprosthesis. The most likely cause is minute particles of fat and bone marrow that enter the circulation during the fixation of the endoprosthesis with bone cement.

To prevent possible bone cement implantation syndrome, the surgeon will thoroughly rinse the bone prepared for the endoprosthesis with an isotonic solution before inserting the bone cement.

Mechanical problems as well as infections can lead to loosening of the endoprosthesis just several weeks, or a few months after the operation. This loosening manifests as pain and restricted mobility. With infections, fever and fatigue may also be present.

  • The triggers for an endoprosthesis infection occurring soon after surgery are usually bacteria that spread through the circulatory system and colonise the artificial joint. If a patient develops a bladder, tooth canal or sinus infection, he or she is encouraged to visit their general practitioner for treatment.
  • More commonly, bacteria colonise the endoprosthesis during surgery but signs of infection are only seen after a delay of months. As a preventive measure, bone cements with an added antibiotic are often used during the joint replacement surgery.

If an infection develops, the endoprosthesis colonised by the bacteria usually has to be replaced by a new joint (revision surgery).

Certain movements or a fall can lead to the head of the artificial joint popping out of the socket – this is referred to as dislocation of the endoprosthesis. This dislocation is painful and the joint can barely be moved. The joint is usually reset under anaesthetic.

Painful sites of calcification can develop in the tissue around the hip endoprosthesis in the weeks or months following the surgery. The calcification can be prevented by taking anti-inflammatory medications. Alternatively, preventive and therapeutic radiotherapy on the operated hip joint can be used.

After knee replacement surgery painful adhesions on the joint capsule can develop. Preventive physiotherapy exercises should be started soon after the surgery, even the day after.

For further questions please contact your doctor.