Post-operative complications following total joint replacement

Early post-operative complications:

• Infection
• Thromboembolism
• Dislocation

Early increase in pain, redness or significant swelling around the wound are indications to refer the patient straight back to the treating surgeon.

Calf pain, swelling of the ankle or calf should be investigated urgently.

Chest symptoms should be investigated for a pulmonary embolus and are best treated in a hospital environment.

Sudden pain in the hip and shortening of the leg indicates dislocation, which needs urgent x-ray and referral.

Long term major complications:

• Infection
• Loosening

If the patient develops pain in their joint of a relatively quick onset, particularly associated with any other operative procedure, infection should be suspected and investigated. It is very important to the patient’s primary treating physician that, if the patient has any operative or dental procedures, they are covered by suitable antibiotics. This is because bacteria seeding into the joint from any bacteraemia is possible.

Loosening can occur at any time and this is why the patient should be seen by their orthopaedic surgeon every year or two after the initial rehabilitation phase. X-rays may pick up changes which do not become symptomatic for a significant period of time.