Total Hip Replacement (cont.)
What are the risks of total hip replacement?
The risks of total hip replacement
include blood clots in the lower extremities that can travel to
the lungs (pulmonary embolism). Severe cases of pulmonary embolism
are rare but can cause respiratory failure and shock. Other problems
include difficulty with urination, local skin or joint infection,
fracture of the bone during and after surgery, scarring and limitation
of motion of the hip, and loosening of the prosthesis which eventually
leads to prosthesis failure. Because total hip joint replacement
requires anesthesia, the usual risks of anesthesia apply and include
heart arrhythmias, liver toxicity, and pneumonia.
What does the preoperative evaluation
entail?
Total hip joint replacement can involve
blood loss. Patients planning to undergo total hip replacement
often will donate their own (autologous) blood to be banked for
transfusion during the surgery. Should blood transfusion be required,
the patient will have the advantage of having his or her own blood
available, thus minimizing the risks of blood transfusions. The
preoperative evaluation generally includes a review of all medications
being taken by the patient. Antiinflammatory medications, including
aspirin, are often discontinued one week prior to surgery because
of the effect of these medications on platelet function and blood
clotting. They may be reinstituted after surgery. Other preoperative
evaluations include complete blood counts, electrolytes (potassium,
sodium, chloride, bicarbonate), blood tests for kidney and liver
functions, urinalysis, chest x-ray, EKG, and a physical examination.
Any indications of infection, severe heart or lung disease, or
active metabolic disturbances such as uncontrolled diabetes may
postpone or defer total hip joint surgery.
Next: What will it be like for the patient after surgery? »
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