Q9 – Late Complications Questions
Part 9 – Late Possible Complications and Risks
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Question 1 of 4
1. Question
Question 1
If deep infection occurs it is likely;
CorrectIncorrectHint
Infection (RISK: <1%).
Deep infection of the hip joint can occur at any time, but is rare. This typically follows a period when you might be unwell with flu-like symptoms.
Infection is usually “opportunistic”, meaning that bacteria can take advantage of a situation whereby you are immunocompromised because of the recent illness. Infection may present with insidious pain, and it is rare for the wound to be red or inflamed. You may feel listless and unwell, and off your food.
The more chronic the infection becomes, the more likely it is to develop a wound sinus, whereby pus escapes through a small break in the skin. This is a clear sign of infection.
If infection is diagnosed early, it may be necessary to go on a prolonged course of antibiotics. If diagnosed after 6-8 weeks, it may be necessary to open the wound and wash and debride the tissues. It would be likely that some, if not all, of the implant would have to be removed at this stage.
Occasionally it is necessary to perform a “two-stage” revision surgery, whereby the implant is removed at the first stage, and an antibiotic-loaded spacer is implanted.
Following approximately 3 months of antibiotic therapy and monitoring of blood tests, a second operation is performed to implant a new prosthesis.
You will again be on a prolonged period of antibiotics following this procedure.
See video: 00:00 – 01:33
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Question 2 of 4
2. Question
Question 2
If the implant becomes loose you would have pain;
CorrectIncorrectHint
Aseptic loosening (RISK: <1%).
Over time the implant may become loose for unknown reasons.
This would manifest by new onset pain, usually in the thigh, and occasionally the sensation of the implant being loose in the hip. It would be necessary in these circumstances to undergo further surgery and revise the implant.
See video: 04:15 – 04:40
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Question 3 of 4
3. Question
Question 3
Squeaking can occur with;
CorrectIncorrectHint
Squeaking (RISK: <1%).
It is more common nowadays for a surgeon to use ceramic as the bearing surface of the hip.
This is commonly done for younger patients. While ceramic is a better lubricating material than metal and plastic, it can rarely squeak upon walking. This can be a sign of a defect of the ceramic, or that the bearing surfaces have become loose or malpositioned.
It can also be a sign of fracture of the ceramic.
Squeaking does not settle, so it may be necessary to revise the bearing surfaces if this were to happen.
See video: 06:48 – 07:25
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Question 4 of 4
4. Question
Question 4
Metal ions;
CorrectIncorrectHint
Metal ions (RISK: <1%).
The use of metal-on-metal hip implants has largely been abandoned. This is partly due to the unknown effect of metal ions on the general health of the patient. These are minute particles that are shed from the metal-on-metal bearing surface, and get into the bloodstream.
They can lodge in all parts of the body, and there effect is largely unknown. In the very unlikely event that you are undergoing this type of procedure, you should discuss any concerns you have with your surgeon prior to proceeding.
See video: 09:08 – 09:42
