Introduction
In Germany, the use of an artificial hip prosthesis is a frequently performed procedure, which in most cases results in a significant improvement of the quality of life. Nevertheless, in some cases complications occur, so that a hip prosthesis causes pain. The pain can spread from the hip, over the thigh to the knee and often occurs in connection with a hip prosthesis loosening. Pain can also occur immediately after surgery following a hip prosthesis, e.g. if the implant was not inserted optimally. In the following, the causes and severity of the symptoms are discussed in more detail and a brief report is given on diagnosis, therapeutic options, prognosis and prophylaxis.
Causes
There are a number of different causes that can cause pain after the use of a hip prosthesis. Over time, the hip prosthesis may become loose, because even after surgery, a tight-fitting hip prosthesis is not always guaranteed. When a hip prosthesis is loosened, the inserted implant no longer sits firmly in a predetermined place, which leads to severe pain and instability.
A distinction is made between aseptic hip prosthesis loosening, i.e. without the involvement of bacteria, and septic hip prosthesis loosening. In septic hip prosthesis loosening, an infection of the hip prosthesis causes pain through inflammation. Often the smallest amounts of pathogens that have entered the surgical area during the operation are sufficient to continue to grow inside the wound after closure of the wound and damage the tissue surrounding the hip prosthesis.
One of the main causes of the aseptic hip prosthesis loosening, where pain occurs after the hip prosthesis is removed, is wear and tear. On the one hand, a hip prosthesis has reached the end of its durability after 20-30 years, on the other hand, external patient-related factors are added. For example, extreme sports or frequent excessive strain are a risk factor for premature hip prosthesis loosening. Patients should also try to control their own weight, as overweight is a major burden on the prosthesis and can cause pain. A reaction of the bone around the foreign material can cause pain after the operation.