Risks With Surgery
Possible Risk or Complications of Orthopaedic Surgery
Risks and Complications
As with any major surgery, there are potential risks involved in all orthopaedic surgery.
The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or specific to orthopaedics.
Medical Complications
Medical Complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include:
- Allergic reactions to medications
- Blood loss requiring transfusion with its low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia, bladder infections
- Complications from nerve blocks such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalization or rarely death
Specific Complications
Can Include:
Infection
Infection can occur with any operation. In orthopaedics, this can be superficial or deep. Infection rates are approximately 1%, if it occurs it can be treated with antibiotics but may require further surgery. Very rarely your implant may need to be removed to eradicate the infection.
Dislocation
This means the orthopaedic joint comes out of its socket. Precautions need to be taken with your new orthopaedic device so if a dislocation occurs and it needs to be put back into place with an anaesthetic it is addressed quickly. This event rarely becomes a recurrent problem needing further surgery.
Blood clots (Deep Venous Thrombosis)
These can form in the calf muscles and can travel to the lung (Pulmonary embolism). These can occasionally be serious and even life-threatening. If you get calf pain or shortness of breath at any stage, you should notify your surgeon.
Damage to nerves or blood vessels
Also rare but can lead to weakness and loss of sensation in part of the leg. Damage to blood vessels may require further surgery if bleeding is ongoing.
Wound irritation
Your scar can be sensitive or have a surrounding area of numbness. This normally decreases over time and does not lead to any problems with your new joint.
Limb length inequality
It is very difficult to make the leg exactly the same length as the other one. Occasionally the leg or arm is deliberately lengthened to make the new joint stable during surgery.
There are some occasions when it is simply not possible to match the limb lengths. Limb length inequalities can be treated by a raised shoes or the like.
Wear
All joints eventually wear out. The more active you are, the quicker this will occur. In general, 80-90% of joint or limb replacements survive 15-20 years.
Failure to relieve pain
Very rare but may occur especially if some pain is coming from other areas such as the spine.
Unsightly or thickened scar
Limp due to muscle weakness
Fractures (break) of the femur (thigh bone) or pelvis (hipbone). Or other local bones are also rare but can occur during or after surgery. This may prolong your recovery, or require further surgery. Discuss your concerns thoroughly with your orthopaedic surgeon prior to surgery.
Summary
Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it could mean the difference between leading a normal life or putting up with a debilitating condition.
Surgery can be regarded as part of your treatment plan- it may help to restore function to your damaged joints as well as relieve pain.
Risk Mitigation
Get Moving Quickly
Early mobilisation is a major preventive measure. We strongly encourage you to get moving and out of bed as soon as possible after the operation to restore normal blood flow in the legs.
You should aim to do at least ten short walks (of between 2 and 5 minutes) each day in the first two weeks after surgery.
How can I minimise Post Operative Complications
Blood clots (DVT or PE) - All patients receive a number of treatment measures to reduce the risk of blood clots. These include being given injections of heparin during and after surgery, special leg stockings (TEDS), and the sequential calf compression device (SCD) whilst on the operating table.
Any patient who is at high risk of a blood clot (such as a history of blood clots or clotting disorders) may be asked to continue heparin (Clexane) injections for 10 days after the surgery in addition to the other measures. This can be done at home, and we will show you how.
