La cirugía de reemplazo ip y la cirugía de reemplazo de rodilla se realizan para el tratamiento de la artritis grave . Durante estos procedimientos, la articulación artrítica se retira y se reemplaza con un implante artificial . Antes de la cirugía de reemplazo de articulación, debe tener una discusión muy seria con su médico y recibir respuestas a sus preguntas . Debe comprender los riesgos potenciales de la cirugía de reemplazo articular .
La cirugía de reemplazo articular es un procedimiento seguro. Sin embargo, existen complicaciones potenciales asociadas con esta cirugía. Todos los pacientes que se someten a un reemplazo articular deben comprender los riesgos potenciales de la cirugía de reemplazo articular .
Los coágulos de sangre en las venas grandes de la pierna y la pelvis ( trombosis venosa profunda o TVP) son comunes después de la cirugía de reemplazo articular. Para minimizar el riesgo de desarrollar coágulos sanguíneos, su médico lo iniciará con un medicamento para adelgazar la sangre que continuará durante varias semanas después de su reemplazo articular. Además, le darán medias de compresión para mantener la circulación de la sangre en las piernas. La movilización temprana con terapia después de la cirugía también ayudará a prevenir la formación de coágulos de sangre .
The concern is that if a blood clot develops, it is possible that the clot can travel to the lungs (called a pulmonary embolism), which can be potentially fatal. If your doctor finds evidence of blood clot formation, you will likely be given a higher dose of blood thinning medication for a longer period of time.
Infection of a joint replacement is a very serious complication and may necessitate removal of the joint replacement implant. Infections sometimes occur in the days and weeks following surgery (early infection) or years down the road (late infection). An attempt to surgically clear the infection and leave the implants in place is sometimes made, especially in the setting of an early infection. However, some infections require removal of the implants, followed by weeks of IV antibiotics. To reduce the risk of an infection once you have a joint replacement, you may be told to take antibiotics when invasive procedures (such as dental work or colonoscopies) are performed.
When surgery is performed, your body’s natural response is to make scar tissue. This is true both on the skin and deep down inside the joint. Because scars contract, a tightening of the soft tissues around your joints can occur. If this occurs after a knee or hip replacement procedure, you may have difficulty bending your knee, sitting in a chair, or walking up and down stairs. Because of this, it is important to begin activity as soon as possible after surgery. Aggressive physical therapy must be continued for months following the surgery. If stiffness persists despite physical therapy, a manipulation under anesthesia may be performed. This breaks up scar tissue, but it will require you to again be aggressive with physical therapy.
Over time, implants wear out and may loosen. New technology has helped this problem, but wearing out of implants and loosening still occur. Most hip and knee replacements last an average of about 20 years. Some last less than 10, some more than 30, but every implant eventually wears out. This is more of a problem in younger patients, who live longer and typically place more demands on the implanted joint.
If the joint wears out, a revision replacement (replacement of a replacement) may be performed. This is a more complicated surgery, and the lifespan of the implant decreases with each revision surgery. This is one reason why physicians often delay joint replacement surgery as long as possible, especially in younger patients.
Dislocation of a hip replacement occurs when the ball dislodges from the socket. This can occur for many reasons but often occurs after a fall or in patients with problems such as Parkinson’s disease. Hip dislocation can even occur with simple activities such as while sitting down on a low seat. For this reason, you may be instructed to follow “hip precautions“. These precautions include:
- Not crossing your legs
- Using elevated seats
- Not bending your hip up more than 90 degrees (toward your chest)
- Sleeping with a pillow between your legs
- Avoiding turning your foot inward
Is Joint Replacement Too Risky?
These are some of the common complications following surgery, though this is by no means comprehensive. Before undergoing this surgery you should have a long discussion with your doctor and ask all your questions. You may be referred to an internist to have a full medical evaluation before surgery and discuss any medical issues that may be unique for you.
Joint replacement surgery is outstanding — the results have been excellent, and the outcome of most patients is wonderful. However, there are risks to this surgery, and it is important to understand these before you proceed.
I am Dr. Christopher Loynes and I specialize in Bone Marrow Transplantation, Hematologic Neoplasms, and Leukemia. I graduated from the American University of Beirut, Beirut. I work at New York Bone Marrow Transplantation
Hospital and Hematologic Neoplasms. I am also the Faculty of Medicine at the American University of New York.