Types of Total Joint Implant Complications

Total joint implant surgery, also called total joint replacement surgery, involves replacing a damaged or dysfunctional joint with durable prosthetic parts. Doctors may recommend it if the bones of a joint are fractured, arthritic, or diseased.

Hip, knee, and shoulder replacements are the most common procedures, but orthopedic surgeons at NYU Langone Orthopedic Hospital and NYU Langone Orthopedic Center also perform surgery to replace joints in other areas, including the ankle, elbow, wrist, and hand. Often, the procedure relieves pain, improves mobility, and restores joint function, improving a person’s quality of life.

As with any surgery, there are possible complications. At NYU Langone, orthopedic surgeons perform more than 3,000 joint implant procedures each year with a complication rate of less than 1 percent. When a complication occurs, our doctors have the experience to recognize the symptoms and determine the cause. Possible complications include the following.

Joint Implant Infection

After surgery, the incision site and the implant are vulnerable to infection. Any time the skin is cut, germs may enter the bloodstream. Normally, the body’s immune system fights off bacteria, but the metal and plastic parts that comprise joint implants may confuse the immune system and prevent it from functioning well. If the immune system is not able to destroy the bacteria, the organisms may travel through the bloodstream to other parts of the body, including the implant.

Most of the time, doctors diagnose and manage a surgical site infection before it reaches the deeper tissues near the joint implant. However, an infection in the joint implant may develop months or years after surgery for reasons unrelated to the incision. For instance, dental procedures often create a deep open wound in the mouth that is susceptible to infection, which can travel to the joint.

Our doctors follow a comprehensive pre- and postsurgical protocol to minimize the risk of infection. After surgery, your doctor gives you detailed instructions on how to care for the surgical site at home.

Blood Clots

Blood clots can develop after surgery because people are often less active while they’re recovering. This slows blood flow and increases the risk of blood pooling in veins, leading to a clot. The clot can block blood flow, resulting in vein damage, swelling, and pain.

A blood clot that forms in a vein deep within the body, usually the legs, is called a deep vein thrombosis. If a clot dislodges from a vein in the leg and travels through the bloodstream to the lungs, it may block blood flow. This is known as a pulmonary embolism, and it can be life threatening without immediate treatment.

Vascular specialists at NYU Langone’s Venous Thromboembolic Center (VTEC) offer expert care for any complication involving a blood clot.

Joint Dislocation

After joint implant surgery, there is a small risk of dislocation, in which the components of the new joint separate. It’s most common in the hip, but it can sometimes occur in the knee. Dislocation can cause pain and make it difficult or impossible to use the new joint.

The risk of dislocation is greatest in the first few months after surgery, when the surrounding muscles and soft tissues are healing.

Joint Implant Loosening

Joint implants are made of durable materials, including plastic, metal, and ceramic, and are firmly implanted into the surrounding bone during surgery. Newer designs can function for as long as 20 years, allowing many people to remain active after an injury or arthritis has damaged the natural joint. After years of use, however, the prosthetic parts may become loose or detach from the bone.

Neurovascular Injury

Less commonly, surgery may injure the nerves or blood vessels near a joint implant. There are many nerves and blood vessels in the body, and surgeons have to work around them.

Our surgeons use techniques and instruments to minimize the risk of damage to nerves or blood vessels, and the rate of neurovascular injury at NYU Langone is very low. But if blood supply to a bone near an implant is restricted or blocked as a result of surgery, the bone may deteriorate from lack of nutrients. This is called osteonecrosis.

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