A fracture of the femoral neck a short while after hip resurfacing surgery. This situation was salvaged quite quickly and easily by converting the hip resurfacing to a total hip replacement.

A fracture of the femoral neck a short while after hip resurfacing surgery. This situation was salvaged quite quickly and easily by converting the hip resurfacing to a total hip replacement.

Although hip resurfacing is an astonishingly successful operation, it would be wrong to pretend that surgery always proceeds as planned. Complications do occur, and it is essential that all patients contemplating surgery are aware of their existence. However, please do not allow your imagination to blow matters out of proportion. In reality, complications are infrequent and most are reversible. Many of the complications associated with total hip replacement also apply to hip resurfacing.

Complications are of three sorts:

  • Operative
  • Post-operative
  • Long-term (six months or more after surgery)

Operative complications

  • Nerve Damage
  • Vascular Damage
  • Coritical perforation
  • Fracture
  • Leg length inequality (risk: 6%)
  • Entrapped drain
  • Cement extrusion
  • Anaesthetic complications

Post-operative complications

  • Nerve damage
  • Fracture (risk: 2%)
  • Dislocation
  • Infection
  • Trochanteric problems
  • Bowel complications (risk: 1%)
  • Urinary complications
  • Haematoma formation
  • Cardiovascular complications, including deep vein thrombosis
  • Wound dehiscence
  • Respiratory complications
  • Prosthetic displacement
  • Knee pain
  • Swollen ankles
  • Skin complications
  • Metabolic complications
  • Death (risk: 1%)

Long-term complications

  • Aseptic loosening
  • Bone stock loss with femoral neck resorption
  • Component fracture
  • Late dislocation
  • Late infection (risk: less than 1%)
  • Bone fracture (risk: less than 1%)
  • Ectopic ossification
  • Allergic reaction (ALVAL)
  • Pseudotumour formation
  • High serum metal levels
  • Tendonitis (e.g. iliopsoas)

The list above will appear long to anyone who wishes to undergo hip resurfacing surgery. Unfortunately it represents the reality of the situation and, perhaps, concentrates the mind as to whether or not surgery is definitely needed. Please also understand that the list is not comprehensive. This is why a surgeon will frequently struggle to dissuade a patient from having a hip resurfacing. Some of the terms used may be unfamiliar to you. If so, please ask your surgeon for further details.