What is it about ?
An arthroplasty is a procedure performed to place a joint prosthesis to replace the original joint. Two complications can occur:
- Infection of the prosthesis;
- Wear and / or loosening of the prosthesis.
How to recognize them?
Infection of the prosthesis
An infection of the prosthesis can occur early (in the month following the operation) (early infection) or late (more than a month after the operation) (late infection).
The symptoms are identical in both cases, but are more marked in case of early infection:
- Pain ;
- Redness;
- Swelling;
- Local heat;
- Loss of joint function: it is no longer possible to move the joint normally;
- Fever, possibly
- The surgical scar may flow (ooze).
If the infection spreads to the blood circulation, there are always more important symptoms: high fever, malaise, loss of appetite, signs of inflammation elsewhere than in the joint.
In case of late infection, the symptoms are usually less marked. The most striking symptom is pain that lasts after the procedure. Normally, this pain gradually subsides. If not, or if the pain in the joint increases, it still indicates a problem.
Wear and loosening of the prosthesis
In case of wear and loosening of the prosthesis, you will mainly have complaints about the prosthesis. In this case, you will feel pain when loading the joint (work, sport), and swelling may develop.
At a later stage, you may hear a clicking or clicking sound that comes from the prosthesis.
Finally, the joint becomes unstable and, like with a hip prosthesis, you have the feeling that the joint is slipping out from under you, especially when you go down a flight of stairs.
How is the diagnosis made?
Faced with complaints after the fitting of a joint prosthesis, the doctor will rely on 2 examinations:
- A blood test (blood test) to look for signs of infection;
- An x-ray to see the prosthesis. Generally, the images quickly show a possible loosening.
What can you do ?
It is important to prevent any infection.
If you have a prosthesis, it is important not to get an infection elsewhere.
Report any abnormalities (skin injuries such as ulcers, eczema, fungi) to the doctor, even if they are not at the location of the prosthesis. Infections that develop between the fingers and toes can, for example, be a source of contamination elsewhere in the body.
Good hygiene of the mouth and teeth is very important. If you have problems with your teeth, consult your dentist before the procedure.
After the procedure, it is especially important to see a doctor immediately if you have any symptoms. The sooner a problem is treated, the better, as a chronic infection can lead to loss of the prosthesis.
After removing the staples (sutures), there may be temporary redness and oozing from the surgical wound. This is perfectly normal. Be sure to treat the wound properly by disinfecting and covering it. The oozing from the wound should neither increase nor last.
What can the doctor do?
If he suspects a complication, the general practitioner will always refer you to the surgeon who operated on you. If he thinks of an infection in the wound, he will send a sample of the fluid oozing from the wound to the lab to identify the germ that caused the infection and determine the most effective antibiotic.
In case of early infection of the prosthesis, the surgical wound should usually be reopened and treatment with high dose antibiotics should be given as an infusion. This treatment is essential to stop the infection. If an infection develops again after treatment, further intervention is required.
In the event of late chronic infection, it is generally no longer possible to save the prosthesis. This is then removed and replaced with a new prosthesis after taking antibiotics.
In order to avoid these complications, you must consult the orthopedist regularly during the first months following the operation. A follow-up x-ray will be done after one year, even if everything is fine, then every 2 to 5 years.
Want to know more?
- Total knee replacement: preparing for the operation – CHU Montreal
- Total hip replacement: preparing for the operation – CHU Montreal
- Total knee replacement: taking care of yourself after the operation – CHU Montreal
- Total hip replacement: taking care of yourself after the operation – CHU Montreal
Source