Avoiding Complications

Potential Infections

Less than 1% of people will get an infection around their new joint. An infection can reach the new joint through the bloodstream. People who develop infections usually need antibiotics and, sometimes, may need more surgery.

To prevent infection, it is important to keep your incision and dressings dry. Do not touch your incision and keep the surrounding skin clean.

Below is a list of the different types of infections that could occur, along with their signs and symptoms. 

Incision Infection

Possible signs and symptoms of an incision infection are:

• The area around your incision is becoming red, and the redness is spreading.
• Green, yellow or smelly pus is coming from your incision site. It is common for fluids to drain for 3-5 days after surgery. However, this should stop, and your incision should remain dry.
• Increased pain or swelling occurs around the incision and surrounding area.
• Your temperature rises above 38°C or 101°F.

Bladder Infection

Possible signs and symptoms of a bladder infection are:

• It hurts or burns when you urinate.
• You need to urinate more often than normal.
• Your urine smells very bad.
• Your temperature rises above 38°C or 101°F.

Chest Infection

Possible signs and symptoms of a chest infection are:

• You cough a lot, or cough up yellow or green mucous.
• Shortness of breath.
• Fever above 38°C or 101°F.

Blood Clots

You have a higher risk of getting a blood clot after surgery. Blood clots usually develop in the deep veins in the legs, in a condition called Deep Vein Thrombosis (DVT).

People who have problems with their circulation or are inactive are more likely to develop a blood clot. It is very important to do your exercises and move around as much as you can after surgery to prevent blood clots.  

Foot and ankle pumping exercise is highly recommended as a method to prevent blood clots:

Signs of a blood clot in your leg are:

• Increased pain, swelling or tenderness in the calf or thigh of either leg – not just your surgical leg, or in the groin area
• lower leg may become hot and red

This condition requires medical attention. If you are at home, and notice any of these signs, seek medical attention.

In some cases, a blood clot can break off and travel from your leg to your lungs, causing a lung clot, called a Pulmonary Embolism. While this is a rare event, it’s good to know the signs and to understand that this is a medical emergency.

Possible signs of a blood clot in your lung are:

• sharp chest pain
• a rapid heartbeat
• blood in your spit
• shortness of breath, or
• a low fever

This condition can be life-threatening. If you are at home and notice any of these signs, call 911.

For more information on preventing blood clots, see Preventing Blood Clots.

Swelling 

It is normal to have pain, swelling and even blisters in your leg after surgery and during your recovery. But as the days go by, the pain and swelling should get less and less.

Some things to do to help reduce swelling:

• Ankle pumping exercises, as you are able to.
• Do short periods of activity. It is better to start with short walks, done frequently, over the day. Be sure to balance rest and activity.
• Place an ice pack wrapped in a towel on your joint for 10-15 minutes, three times a day, after you do your exercises. Some people use a “cryocuff” – a type of ice pack that wraps around your lower leg. For more information, talk to your physiotherapist about using ice at home.
• You may wear special stockings ordered by your doctor, called Compression Stockings or TEDs. These elastic stockings put pressure on your legs after your surgery, and help the blood flow through your blood vessels. These stockings help prevent deep vein thrombosis (DVT), blood clots that form inside veins and block the blood flow.

Constipation

Constipation after your surgery can become a problem because of a change in your diet, less activity and the effects of the pain medicine.

Prevention is best way to avoid constipation

• Eat lots of fibre. Aim for 25 to 35 grams of fibre every day by eating such foods as prunes, bran, beans, lentils, fruits and vegetables.
• Drink plenty of fluids. Try to drink at least 8 cups (2 litres) of water or low-calorie fluid every day.
• Move around as much as you can – do your exercises!

Your nurse may give you laxatives or stool softeners. You may need to keep taking these medicines at home. If you have constipation at home, talk to your pharmacist. Constipation can be serious, so don’t ignore your symptoms!

Anemia (low blood count)

Anemia after joint replacement surgery could result from blood loss from surgery. If you show any signs of anemia (the medical term for not having enough blood in the body) contact your family doctor.  You may need an iron supplement. The signs of anemia are: 

• Feeling dizzy or faint
• Feeling very tired
• Shortness of breath with or without activity
• Rapid pulse

Joint Loosening

Over many years, the bond between the joint replacement and your bone may loosen. This can cause pain and make it difficult for you to move your new joint. To lower the chances of this happening, avoid high-impact physical activities. If you notice more pain in your new joint, talk to your doctor right away.

Call 911 if your surgical leg is suddenly extremely painful, shortened or the hip cannot be moved.

Hip Joint Dislocation (for Hip Replacement Surgery patients only)

If your hip joint moves out of place, you may notice:

• Severe pain such that you may be unable to move or bear weight on the affected leg
• A change in where you feel the pain in your hip.
• A change in the shape of your hip.
• Your hip gets stuck in one position.

Call 911 if your surgical leg is suddenly extremely painful, shortened or the hip cannot be moved.

Dental Work and Medical Procedures

Tell your health care professional that you have had joint replacement surgery before having any dental or medical work done (including anything to do with the bladder, prostate, lung or colon). You may be put on antibiotics to prevent infection from moving through your bloodstream to your new joint. Talk to your dentist or doctor about what is right for you.

IMPORTANT: You are responsible for taking steps to prevent infection for at least two years after your surgery. Before you have any other kind of surgery or a test that involves inserting instruments into your body, tell the specialist doctor about your joint replacement operation. You might need to take antibiotics.

When to Call Your Doctor

Call your family doctor or surgeon if you have:

• Pain, aches, heat or redness in your calf
• Bad swelling in either leg
• Fever above 38°C or 101°F

Call 911 immediately if you have:

• Shortness of breath
• Sudden chest pain