What You Need to Know

Possible Adverse Events

Going in to any surgery you would want to know any complications that could potentially happen afterwards, it doesn’t mean you can’t get back to the maximum outcome, it just means there may be some setbacks to achieve that.

Attention!

For non-emergent questions or concerns please call our office numbers 412-641-8609 or 412-683-7272 for all other concerns and questions.
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We always have someone on call 24/7 (including holidays) and will be able to assist your hip and knee specific needs.

In the case of a true medical emergency please call 911.

Infections

Infections can occur after any surgery. We take special steps to prevent infections. These include cleaning the skin with special soap to kill bacteria before surgery, use of antibiotics, and covering the skin with a sterile dressing (e.g., when showering).

There are two types of infections:

1. Minor or “superficial” infections that occur in the skin around the incision. This type of infection is treated with antibiotics, closely watching the incision, and sometimes special cleaning of the area.

2. “Deep” infections are more serious and involve the tissues inside the new joint and surrounding bone. This type of infection may require additional surgery to clean the joint and the area around the joint. Rarely, removal of the joint may be needed. The joint is then replaced at a later date once the infection is eradicated.

Bleeding

Some bleeding is expected during and after surgery. Less than 1% of patients in our program require a blood transfusion after surgery. Rarely, a patient may have to be taken back to surgery if the bleeding continues. There are steps that may be taken before surgery to reduce the amount of blood loss. For instance, if you are taking blood thinners, you will be told to stop taking them a week before surgery. We also will give you a special medicine (TXA) before and after your surgery that reduces bleeding.

Leg Length Discrepancy

Some patients may feel that their legs are different lengths. This may be present before surgery because of arthritis in the hip, knee, or spine or tightening of tendons or ligaments. During hip replacement surgery, many times the leg must be lengthened in order to tighten up the muscles that hold the joint in place and restore normal mechanics. This also helps prevent the joint from dislocating. It can take a few months to readjust and feel "balanced". Or you may not even notice the differences.

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Loosening of the Implant

This may occur over the course of time. However, approximately 90% of patients still have their original hip or knee replacements at 20 years or more. If loosening becomes a problem, surgery (called a revision) may be needed. Sometimes, only a portion of the implant needs replaced, not the entire implant.

Dislocation

Dislocation is most commonly seen in hip replacement when the joint “pops” out of place. This is usually caused by muscle weakness, poor healing or moving the leg into an extreme position. You will be given instructions on steps you can take to prevent this from happening. Happens more often in the first 2 months post op because the tissues are still soft.

Lack of Motion

Lack of motion after total knee replacement may result in the development of scar tissue. Movement, stretching and physical therapy after surgery will help to prevent this problem. If stiffness persists, a manipulation of the knee under anesthesia may be needed to break up the scar tissue.

Nerve or Blood Vessel Injury

After hip or knee replacement surgery, the skin around the incision can be numb for several months. This is normal and improves over time. In rare instances, it can be permanent.Rarely, there can be damage to nerves or blood vessels that can cause weakness, pain, or change in sensation (feeling) of the leg. These symptoms usually decrease with time, but sometimes only partially.

Fractures

The hip or knee implant must fit correctly and tightly in the bone. The bone must be cut and prepared so that the implant fits. Sometimes this may cause the bone to crack or break. If this happens, the crack or break will need to be repaired during surgery by fixing it with screws, cement, or wires. This may have an impact on your recovery for two reasons. It may limit the amount of weight you can put on your leg until the fracture heals. It may also limit the amount of therapy you can do until the fracture heals.

Blood Clots

Blood clots can develop in the legs after surgery. This is called a DVT (deep vein thrombosis). A blood clot can also develop in or travel to your lungs and this is called a “PE” (pulmonary embolism). Both can be serious, so steps are taken to prevent blood clots. This includes putting you on blood thinners after surgery (Aspirin). You will also be shown exercises called “ankle pumps” that help promote blood flow while in bed. The most important thing you can do to prevent blood clots is to get up and move.

Restless Leg Syndrome

May occur after joint surgery especially after knee replacements.
Feelings of diffuse pain, calf pain, cramping or the sensation to move the leg aroundMostly experienced at night.
Resolves as muscles and joint heal, 8 – 10 weeks after surgeryIf you have “restless” leg before surgery, it may be worse temporarily after surgery.

Resolves as muscles and joint heal, 8 – 10 weeks after surgery. If you have “restless” leg before surgery, it may be worse temporarily after surgery. Consult your PCP to control the condition prior to joint replacement

‍Treatments

‍Anti-inflammatory medications
Walking
Exercising or moving your joint especially at night
Stretching

‍Contact our office if you have any concerns or for further treatment options.

Pneumonia & Breathing Problems

Another problem that may happen after surgery is pneumonia or lung infection. There are steps that can be taken after surgery to help prevent pneumonia. An “incentive spirometer” will be given to you after surgery, which is an exercise machine for your lungs. A nurse will show you how to use this to “exercise” your lungs. Coughing and deep breathing after surgery also help prevent pneumonia. Again, getting up and walking is a crucial step in preventing pneumonia.

Additional Medical Problems

Other problems may occur after surgery such as: nausea, vomiting, constipation, kidney problems, chest pain, heart palpitations or heart attack. These may be caused by existing medical conditions, the stress placed on the body during or after surgery, and/or medications. Prior to surgery, you will have testing which includes a physical exam, blood work, an EKG and possibly a chest x-ray. You may also need to be examined by your primary care physician (PCP) or a specialist (for example a cardiologist) before surgery. Results of all tests and information from your PCP or other specialists will be reviewed before your surgery. Any existing medical conditions are watched closely after surgery to prevent problems from occurring. However, if any problems do occur, a specialist will be consulted to ensure proper treatment.

Death

As with any surgery, death is always a consideration (although very, very rare).Your specific risk depends on your overall health and any chronic health problems.