Glamorous celebrity, Zsa Zsa Gabor, 93, made headlines recently, not to highlight another marriage, but to inform the public about her recent hip replacement surgery and the complications she is suffering as a result.
Earlier this summer, Gabor fell from her bed in her home in California and sustained a broken hip from that incident. She underwent emergency surgery to repair the broken hip. After being hospitalized for almost a month, the famous actress returned to her Bel-Air home to convalesce. However, shortly after her return home, she was rushed once again to the hospital to undergo another emergency operation to remove a blood clot, a complication related to her recent hip surgery.
Instead of opting to undergo the knife once again on her hip, Gabor and her eighth husband, Prince Frederic Von Anhalt, decided to just let Gabor return home and allow her to rest comfortably there. Doctors indicated that had Gabor agreed to additional surgery on her hip, her recovery chances were 50-50.
This begs the obvious question: What exactly are the possible complications stemming from hip replacement surgery? As we all know, even the smallest of surgeries carries with it some degree of risk for subsequent complications. Hip replacement surgery is no exception, but, fortunately, this type of procedure is very successful and resulting complications are rare, considering how complex the actual surgery truly is.
According to the website for The Hip and Knee Institute in Los Angeles County (www.hipsandkness.com), most complications (from hip replacement surgery) are temporary setbacks. One can have about a 98 percent chance of going through the operation without some significant complication which causes an ongoing problem. The most common complication is one of blood clots in the legs, as evidenced by the news story of Gabor. The most important long-term complication is loosening and wear.
The article on the website indicates that as long as the blood clots remain in the legs, they do not represent a major problem. On occasion, they can dislodge and travel to the lungs, creating a pulmonary embolism. The chances of such an occurrence are one out of several hundred. A blood-thinning drug such as Coumadin can be prescribed to prevent clots from forming after the surgery. Also, compressive calf pumps are used and the patient is also encouraged to perform leg exercises that help to prevent the development of clots. Even though the blood clots can occur despite these preventative measures, they are usually not dangerous if treated appropriately.
Another complication of hip replacement surgery can be in the form of infection. Bacteria can enter the open wound during the actual surgical procedure in the operating room. Usually, antibiotics can be given to the patient before, during, and after the procedure to reduce the risk of infection. It is noted that the patient’s risk of infection during the weeks after the operation can increase if the patient is suffering from rheumatoid arthritis or diabetes, or if the patient has been taking cortisone for an appreciable length of time. Also, if the affected joint has sustained prior infection or if there is an infection elsewhere in the body at the time of the surgery, the risk for infection post-operation is increased.
As for the long-term problems associated with hip replacement surgery, there is the possibility that the prosthesis will loosen from the bone. This is a result of how well the surgery is done, the quality of the patient’s bones in the first place, how active the patient is, the weight of the patient, the design of the implant, and whether or not the implant is cemented.
It is best to find a surgeon who has significant experience with this type of surgery and whose practice is limited to joint replacement surgery. The harder your bones are, the longer your replacement will endure. Those patients with rheumatoid arthritis tend to have soft bones. If you engage in high-impact activities after recovering from the surgery, that could loosen the bond from the bone. While you probably don’t want to spend the rest of your life in bed to avoid anything that could possibly loosen the prosthesis, just be sure to use common sense when performing any type of activity. Additional body weight can add to the stress on the prosthesis. Remember that for every pound of weight gained, that will add three pounds of force to the hip.
In a small percentage of patients, the hip replacement can become dislocated, regardless of the skill of the surgeon. When dislocation occurs, this means that the metal ball slips out of the plastic socket. Six weeks post-surgery, the ball is just held in the socket by muscle tension. This is when scar tissue begins to form around it. If the muscle strength has not fully returned, the hip is more susceptible to dislocating.
In less than one percent of cases, extra bone forms around the artificial hip. This creates extra stiffness in the hip. It can usually be treated by surgical removal of the extra bone once it is mature. Also, the femur can fracture during the hip replacement operation, whether a small crack or a major fracture. If this does occur, it may require the patient to use crutches for up to three months to allow for complete healing. Some fractures may require separate surgical intervention.
Another complication arising from hip replacement surgery is that the length of the leg may be changed. It can be a challenge to get the leg lengths accurate. In some cases, shoe lifts may be necessary if the difference between the legs is in excess of one-quarter of an inch.
Surgery can also result in injury to the arteries or the nerves of the leg. In most cases, a vascular surgeon can repair any damaged vessel if it is recognized early on.
A few other resulting complications from hip replacement surgery include bleeding into the wound in the days following the procedure, complications from the anesthesia, and an allergic reaction to the metal parts.
Again, as stated earlier, all surgeries and procedures carry with them some degree of risk and resulting complications. It is up to the patient and the doctor to determine what the best course of action is for any condition, weighing the pros and cons, and ultimately deciding whether the advantages of surgery to repair a condition outweigh the potential complications.
As for Zsa Zsa Gabor, I think many would agree that she has always been “hip,” and we wish her a speedy recovery and a restful recuperation period at home.