DEAR DOCTOR K >> My doctor says I need hip replacement surgery. She says it will help my pain. But I'm worried about complications. Should I be?

DEAR READER >> I get a lot of questions about hip replacement surgery, and I'm in a good position to answer them: I had a hip replacement about a decade ago. Before I give a more detailed answer, let me cut to the chase — The benefits of hip replacement surgery greatly outweigh the risks.

First, the basics. Your hip is a ball in a socket joint: The big bone in the top part of your leg has a top that's shaped like a ball, and your pelvic bone has a cup into which the ball fits. Hip replacement surgery involves replacing the bony ball and socket with an artificial device made of metal or ceramic.

As with every type of surgery, there can be complications. Fortunately, they are very unusual.

So what can go wrong?

• Blood clots. These can form in the veins of the legs, shake loose, and travel to your lungs. This can be a serious complication. However, treatments have greatly reduced this risk.

• Your implant can become infected. If you feel new pain in the implanted hip, particularly if you also feel sick and have a fever, seek immediate treatment.

• Dislocation. In the weeks after your hip replacement, take great care to keep from dislocating your implant before the surrounding tissues have healed enough to hold it in place. To reduce dislocation risk, do not bend over farther than your waist for about six weeks after your surgery. Also avoid turning your recuperating leg in or out. Even afterward, there is a chance of a painful dislocation.


• Leg-length discrepancy. After surgery, your legs may become slightly unequal in length. If so, a lift in the shoe of the shorter leg can fix the problem.

• Loosening. A replacement joint can loosen because the cement never secured it properly or eventually wore out. This may also happen if the surrounding bone does not grow into the implant.

• Bone loss. As a joint implant suffers wear and tear, loose particles can be released into the joint. As your immune system attacks these particles, it can also attack surrounding bone and weaken it.

I'm not minimizing any of the possible complications of hip surgery. But the point is that they are very infrequent. Look for a surgeon who performs lots of hip replacements and has a fine reputation. With such a surgeon, the likelihood of any complication is even less. I had no complications. In fact, looking back on it, my only regret about having hip replacement surgery is that I waited so long to have it done!

Dr. Komaroff is a physician and professor at Harvard Medical School.