Chronic hip pain and loss of mobility, typically caused by arthritis, injury or other type of hip disorder, was once considered an inevitable part of aging. Medical technology has since evolved to the point where hip replacement surgery, also known as arthroplasty, has become common for patients with severe or chronic pain. This procedure involves removing the diseased parts of the hip joint and replacing them with artificial parts called prostheses. According to the Centers for Disease Control and Prevention (CDC), 332,000 total hip replacements are performed in the United States each year, and this number is expected to increase significantly in the next decade.
Hip surgery, like any surgical procedure, carries risks. Some complications that can occur include infection, excessive bleeding, adverse reaction to anesthesia, blood clots or heart attack. Sometimes these complications are unavoidable, but other times they are caused by a preventable mistake on the part of the hospital, the surgeon or another member of the medical team.
Mistakes can happen as a result of the surgical procedure or the anesthesia. Some of the most common errors include:
Surgical Mistakes
- “Never Events” such as leaving a surgical instrument or sponge inside the patient or replacing the wrong hip
- Infection from unsanitary instruments or poor sanitizing procedures
- Internal damage caused by careless instrument use
- Nerve damage from accidentally severing or nicking a nerve
Anesthesia Errors
- Failure to take patient’s history into account when administering and monitoring anesthesia
- Physician’s failure to convey necessary information to anesthesiologist
- Incorrect administration or monitoring of anesthesia
Causes of mistakes
Some common reasons mistakes are made during surgery and/or anesthesia include:
- Overtired or overworked surgical staff members
- Charting mistakes
- Poor communication between members of the medical team about a patient’s history and risk factors
- Contaminated instruments or equipment
- Failure to count surgical instruments, sponges and other accessories before and after surgery
- Inadequate hand washing and other sterilization procedures
Types of Hip Implants
According to the U.S. Food and Drug Administration (FDA), there are five main types of total hip replacement devices. A surgeon will determine which type is best for each patient based on a number of factors that include the patient’s age, weight, height, activity level and the cause of hip pain.
Metal-on-Polyethylene: The ball is made of metal and the socket is made of plastic (polyethylene) or has a plastic lining.
Ceramic-on-Polyethylene: The ball is made of ceramic and the socket is made of plastic (polyethylene) or has a plastic lining.
Metal-on-Metal: The ball and socket are both made of metal.
Ceramic-on-Ceramic: The ball is made of ceramic and the socket has a ceramic lining.
Ceramic-on-Metal: The ball is made of ceramic and the socket has a metal lining.
Hip surgery may involve total hip replacement or hip resurfacing.
Total Hip Replacement
During total hip replacement surgery, the damaged portions of the hip joint are removed. The ball (femoral head) is removed and replaced with a prosthetic ball made of metal or ceramic, and the socket (acetabulum) is removed and replaced with a prosthetic cup. The cup consists of one or two components made of metal, ceramic or plastic. A stem is also placed in the femur to support the femoral head, which attaches to the taper of the stem.
Hip Resurfacing
During hip resurfacing surgery, the femoral head is not removed; instead the femoral head is trimmed and capped with a metal covering. Any damaged bone and cartilage within the socket are removed and replaced with a metal shell. In hip resurfacing surgery, both components are made of metal.*
*www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/MetalonMetalHipImplants/ucm241594.htm#risks
Possible Complications of Hip Replacement
Regardless of which type of hip implant system is used, there may be post-surgical complications. As with any surgery, there is the potential for blood clots and infections following surgery, which can be dangerous if left untreated.
Tenderness, redness and swelling of the calf, thigh, ankle or foot could signify a possible blood clot.
Infections are often accompanied by fever, chills, tenderness and swelling or excessive drainage from the wound.
Hip dislocation is the most common problem to arise soon after hip replacement surgery. The artificial ball and socket are smaller than the original ones they replaced, which can allow the ball of the thighbone, or femur to become dislodged from the socket if the hip is placed in certain positions. The most dangerous position usually is pulling the knees up to the chest.
Another common complication, which usually occurs weeks or months after the surgery is an inflammatory reaction to tiny particles that gradually wear off the artificial joint surfaces and are absorbed by the surrounding tissues. The inflammation may trigger the action of special cells that eat away some of the bone, causing the implant to loosen. Anti-inflammatory drugs are often used to treat this complication; occasionally, a second surgery is required.
Other complications include:
- Bone fracture
- Local nerve damage with numbness/weakness
- Device loosening or breaking
- Difference in leg lengths
- Bone loss (osteolysis)
If a hip implant device is not working properly, the symptoms may not show up until three months after the surgery or longer. Some of the signs that a device may not be functioning correctly are:
- Pain in the groin, hip or leg
- Swelling at or near the hip joint
- A limp or change in walking ability
- Noise (popping, grinding, clicking or squeaking) from the hip joint
If you or a loved one has suffered harm from a hip replacement, either from the surgical procedure or the device, and you suspect negligence or a faulty product was involved, contact us immediately for a free consultation.
Our experienced team of medical malpractice lawyers will work with you to determine liability and help you recover the benefits you and your family deserve.
Sources
https://www.consumerreports.org/cro/2013/09/hip-implant-knee-implant-warranty-defective/index.htm