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Risks of hip replacement surgery


There is a risk of complications with all surgeries. Understanding these risks and how they apply to you should be part of deciding whether to have surgery.

Some of these risks may be prevented, or perhaps made less likely, with proper care and planning before surgery. Talk with your doctor long before your surgery about what you can do to prevent problems from happening.

Choose a doctor and hospital that provides high quality care can help lower the risk of complications.

Risks that may occur with any surgery

  • Breathing problems after surgery. They are more common if you have had general anesthesia and a breathing tube.
  • Infection, in the hip, lungs (pneumonia), or urinary tract.
  • Poor wound healing. This is more likely for people who are not healthy before surgery, people who smoke or have diabetes, or people who take medicines that weaken the immune system.
  • An allergic reaction to one of the medicines you take is rare but may occur. Some of these reactions may be life threatening.
  • Falls in hospitals can be a major problem. The cause may be loose gowns, slippery floors, medicines that make you sleepy, pain, unfamiliar surroundings, feeling weak after surgery, or moving around with a lot of tubes coming out of your body.
  • Heart attack or stroke during surgery or afterwards.
  • Injury to your nerves and blood vessels.


It is normal to lose blood during hip replacement surgery. Some people need to have a blood transfusion during surgery or during recovery in the hospital. You are less likely to need a transfusion if you are not anemic before surgery.

Much of the bleeding comes from the raw surface of the bone that has been cut.

A bruise (hematoma) occurs when blood collects around the new hip joint or underneath the skin after surgery.

Blood clots

Your blood is more likely to clot during and soon after hip replacement surgery.

Sitting or lying for long periods of time during and after surgery will make your blood move more slowly through your body. This increases your risk of a blood clot.

Two types of blood clots are:

  • Deep vein thrombosis (DVT). These are blood clots that may form in your leg veins after surgery.
  • Pulmonary embolism. These are blood clots that travel up to the lungs and cause serious problems with your breathing.
  • You can have swelling and pain in your calf with DVT. You can also have shortness of breath or difficulty with deep breaths with pain with pulmonary embolism. Please alert your doctor or go to the emergency room if these symptoms develop after surgery.

Your doctor and nurses can do a number of things to lower the risk for blood clots.

Problems with the new hip joint

These are some problems that may occur after your hip replacement surgery:

  • Infection in your new hip. If this occurs, your new hip joint may need to be removed to clear the infection. This problem is more likely in those with diabetes or a weakened immune system. After surgery, you will learn what you can do to prevent infections in the hip joint.
  • Loosening of your new hip joint. Over time, the hip joint can loosen. This can cause pain, and sometimes another surgery is needed to fix the problem.
  • Dislocation. When the ball slips out of place in the socket, the hip has been dislocated. This problem is most likely to happen in the first 3 months after hip replacement surgery. You will learn proper ways to move your leg and hip to prevent this problem.
  • Fracture. The bone around the prosthesis may be broken after falls or related to stress of the prosthesis. If this occur, your hip prosthesis may need to be removed and a new one being put in.
  • Wear and tear. The moving parts of your hip joint can wear over time. Small pieces may break off and damage the bone. This may require a repeat operation to replace the moving parts and repair the bone.
  • Allergic reaction to the metal parts in some artificial joints. This is rare.

Other risks

The muscles and other soft tissues right around your hip may harden and become bone-like (called heterotopic ossification). This problem may cause a stiff hip joint.

Hip replacement surgery relieves the pain and stiffness of arthritis for most people. Some people may still notice symptoms. It is rare that surgery does not provide a good amount of relief.

Because bone is cut away and a new hip implant is inserted, your leg may be longer or shorter than the other one. This difference is usually about one-fourth of an inch and rarely causes any problems or symptoms. For bigger differences, you may need a heel lift for balance.

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Review Date: 12/31/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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