Complications From a Hip Replacement

Hip replacement surgery can be very beneficial for those who suffer from chronic end-stage arthritis. Removing arthritic joint surfaces and replacing them with artificial components can result in a significant improvement in quality of life. However, for all the benefits that hip replacement surgery provides people with severe degenerative joint disease, the procedure has potential risks and complications.


One of the most devastating complications of any joint replacement surgery, including hip replacement, is infection. Infection can be a post-operative complication, but even more disturbing is the late-onset infection, or an infection which occurs months, even years after the initial replacement surgery.

Infections can be cause by several factors, such as a compromised immune system as seen in patients with diabetes and other autoimmune diseases. They can also be caused by a process known as seeding, where bacteria from other locations on or within the body become transported to the site of the hip replacement through the bloodstream. The microorganisms settle in the hip area, where there is little defense because of the artificial components that lack blood supply; similarly, antibiotics cannot help because of their inability to affect the metallic and plastic components that can harbor the bacteria.

Prosthetic Loosening

Another complication of hip replacement is loosening of the components. Similar to infections, loosening can occur early after the surgery, or months afterward. In cases where the components are cemented into place by special bone cement, loosening can occur in areas where the cement comes into contact with bone, or with the surfaces of the components.

Prosthetic components that are not cemented into place, and are considered a press-fit for purposes of stimulating the patient’s own bone to literally heal to the components, called bio in-growth, can also loosen from insufficient attachment by the bone to the prosthetic components, or from improper sizing or insertion at the time of surgery.

Component Breakage

In some cases, the use of space-age plastic spacers between two metallic components in the hip can result in breakage of that plastic over time. This can occur from a variety of factors, including too thin a spacer, or impact from too vigorous activity or injury such as a fall. In some rare instances, the stem of the component that is inserted into the femur, or thigh bone, can break from unusual or abnormal stress on the metal due to factors such as morbid obesity, high impact activities and faulty manufacturing processes.

Blood Clots

One very important potential complication of hip replacement surgery is the formation of blood clots within the deep veins of the lower extremities, a condition called “deep vein thrombosis.” These clots can be potentially dangerous in that if they are of sufficient size, there is the risk that part, or all, of the clot can break away from its location and travel to the patient’s heart and/or lungs causing a serious complication known as pulmonary embolism. Pulmonary emboli can be extremely serious, and in rare cases, fatal.

According to data published by Georgetown University Hospital, the incidence of clot formation from hip replacement is 10 to 20 percent.

Peri-prosthetic Fracture

Peri-prosthetic fractures refer to broken bones that occur around or very near the components of a hip replacement. The fracture occurs in such a manner as to involve the component, requiring surgical intervention to fix the problem. Fractures that involve the femoral, or thigh bone, component are the most common, while fractures in the pelvis which involve the acetabulum, or cup component, are rarer.

Peri-prosthetic fractures typically require some level of surgical fixation to stabilize the bone to allow for proper healing. If the injury is severe enough to dislodge, or otherwise alter the proper positioning of the component, that component may have to be removed and re-inserted, or be replaced with a component more suitable for this type of scenario.

About this Author

Ken Chisholm is a freelance writer who began writing in 2007 for LIVESTRONG.COM. He has experience in health care, surgery, nursing and orthopedics as an orthopedic physician assistant and a registered nurse. He holds a bachelor\’s degree in business from the University of Findlay, Ohio.