Dr. Carolyn Chambers Clark, Award-Winning Author and Wellness Nurse Practitioner

Hip and Knee Replacement - Dangers and Alternatives

According to the National Institutes of Health, these are the risks and dangers of hip and/or knee replacements: 

"All surgeries have a risk of complications. Understanding these risks and how they apply to you should be part of deciding whether or not to have surgery."

Prepare yourself for surgery and learn all you can by asking your health care team about what to do to minimize dangers. Read the article on surgery on this web site.

Risks That May Occur with Any Surgery

  • Breathing problems after surgery. These are more common if you have had general anesthesia and a breathing tube.
  • Heart attack or stroke during or after surgery
  • Infection in the knee, 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 any of the medicines you receive is rare, but one 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 attached to your body. "
  • Other sources of falls and inability to heal are eating non-nourishing food prior to surgery, in the hospital, and post-surgery including sugary foods, fried foods, pies, cakes, cookies, sodas, caffeinated drinks, and other foods that interfere with the body's healthy functioning and not eating enough fresh vegetables and fruits to provide needed minerals and vitamins. Dehydration due to not drinking 8-10 glasses of water a day can also lead to dizziness, weakness, blood clots and falls.

Bleeding

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

Much of the bleeding during surgery comes from the bone that has been cut. A hematoma (bruise) may occur if blood collects around the new knee joint or under the skin after surgery.

Blood clots

You are more likely to form a blood clot during and soon after hip- or knee-replacement surgery. Sitting or lying down 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 may travel up to your lungs and cause serious breathing problems.

To lower your risk of blood clots, you:

  • May receive blood thinners before and after surgery
  • May wear compression stocking on your legs after surgery to improve blood flow
  • Will be encouraged to get out of bed and walk in the halls to improve blood flow "
  • Drinking sufficient fluids (8-10 glasses of water a day) will also thin your blood as will white willow (a safer alternative than aspirin) and vitamin E without the dangerous side effects of blood-thinning drugs.

Possible problems with your new joint

Some problems that may occur after your hip- or knee-replacement surgery include:

  • Infection in your new joint. If this occurs, your new joint may need to be removed to clear the infection. This problem is more likely in people who have diabetes or a weakened immune system. After surgery, and often before surgery, you will learn what you can do to prevent infections in your new joint.
  • Loosening of your new joint over time. This can cause pain, and sometimes another surgery is needed to fix the problem.
  • Wear and tear of the moving parts of your new joint over time. Small pieces may break off and damage the bone. This may require another operation to replace the moving parts and repair the bone.
  • An allergic reaction to the metal parts in some artificial joints. 
  • Bear in mind that the body is a marvelous structure capable of healing itself if you fix your lifestyle to aid it, but it will fight alien parts being put into it and try to reject them

Other risks

Other problems from hip- or knee replacement surgery can also occur, but these are rare, including:

  • Not enough pain relief. Joint-replacement surgery relieves the pain and stiffness of arthritis for most patients. Some patients may still have some symptoms of arthritis, though. Surgery usually provides enough relief of symptoms for most people.
  • A longer or shorter leg. Because bone is cut away and a new knee implant is inserted, your leg with the new joint may be longer or shorter than your other leg. This difference is usually about 1/4 of an inch. It rarely causes any problems or symptoms."

With all these risks and dangers, it's prudent to ask your health care practitioner what you can do instead of implanting something in your body. Always take the more conservative approach and take it earlier at the first sign of problems. That way, it is less likely you will need surgery.

In the end, your lifestyle is the one thing you can control and is responsible for most illness.

For example, if you're overweight, you may be stressing your joints; in this case, lose weight. It is a lot less dangerous than surgery. See the article on this web site on weight loss and the e-book on weight loss for help.

If you have arthritis, read the article on this web site on arthritis; it provides some alternatives to surgery.
 
If your joint problems are due to repetitive movements on hard surfaces, switch to softer surfaces and learn alternative movements.

If your joint problems are due to poor nutrition and lack of minerals, find a way to obtain what your body needs. Read the article on this web site on bone health/osteoporosis/ joint pain for ideas.

Become an informed consumer of health care. In the end, no one knows as much about you or cares as much about you as you.

Another consideration is the fact that many of these devices are not made properly or don't fit correctly or may not be installed to fit.

Watch TV and you will see which devices are being recalled and/or lawyers are looking to provide you with damages because of fractured hips, pain that is worse than prior to surgery, and even life-threatening reactions.



References

Lachiewicz PF. Comparison of ACCP and AAOS guidelines for VTE prophylaxis after total hip and total knee arthroplasty. Orthopedics. 2009;32:74-78.

Harkess JW. Arthroplasty of the hip. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 7.

Think positive and you'll be positive!

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