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Risks - Hip replacement

The most common problem that can arise as a result of a hip replacement is loosening of the joint. This causes pain and feeling that the joint is unstable. This happens in around 1 in 10 of cases.

This can be caused by the shaft of the prosthesis becoming loose in the hollow of the thigh bone. It can also be caused by thinning of the bone around the implant.

Loosening of the joint can occur at any time. It normally occurs 10 to 15 years after the original surgery was performed.

Another operation (revision surgery) may be needed. But this cannot be performed in all patients.

Hip dislocation

In around 3 out of every 100 cases the hip joint can come out of its socket. This is most likely to occur in the first few months after surgery when the hip is still healing.

Further surgery will be needed to put the joint back into place.

Wear and tear

Another common complication of surgery is wear and tear of the artificial sockets. Particles can wear off the artificial joint surfaces. These can be absorbed by surrounding tissue, causing loosening of the joint.

If wear or loosening is noticed on X-ray, your surgeon may request regular X-rays. Depending on the severity of the problem, you may be advised to have further surgery.

There has been many reports about metal-on-metal implants wearing sooner than expected. They have also been reported as causing complications.

Ask your GP if you have any concerns about your hip replacement or do not know which type you have.

Joint stiffening

The soft tissues can harden around the implant, causing reduced mobility.

This is not usually painful and can be prevented using medication or radiation therapy. This is a quick and painless procedure. During it, controlled doses of radiation are directed at your hip joint.

Serious complications

Serious complications of a hip replacement are uncommon. They occur in fewer than 1 in a 100 cases.

Blood clots

There's a small risk of developing a blood clot in the first few weeks after surgery. It could be either deep vein thrombosis (DVT) in the leg or pulmonary embolism in the lung.

Symptoms of DVT include:

  • pain, swelling and tenderness in one of your legs (usually in the lower back of your leg)
  • a heavy ache in the affected area
  • warm skin in the area of the clot

Symptoms of pulmonary embolism include:

  • breathlessness, which may come on suddenly or gradually
  • chest pain, which may be worse when you breathe in
  • coughing

If you suspect either of these blood clots, seek immediate medical advice from your doctor or GP.

To reduce your risk of blood clots you may be given blood thinning medication such as warfarin. You might be asked to wear compression stockings.


There is a risk that some bacteria could work its way into the tissue around the artificial hip joint. This can cause an infection.

Symptoms of an infection include:

  • a high temperature (fever) of 38 degrees Celsius or above
  • shaking and chills
  • redness and swelling at the site of the surgery
  • a discharge of liquid from the site of the surgery
  • hip pain that can persist even when resting

Seek immediate medical advice if you think you may have an infection.

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 22 December 2020
Next review due: 22 December 2023

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.