Managing Complications After Joint Replacement Surgery: What to Do Next

Q: Managing Complications After Joint Replacement Surgery: What to Do Next

Hello： If there is a suspicion of infection, you should consult an orthopedic specialist first, rather than a general surgeon, because there is an artificial joint involved. <br>The orthopedic specialist will have a better understanding of how to treat this condition. <br>Thank y

Artificial joint

Hello Dr.
Wang: My mother-in-law had a joint replacement surgery five years ago.
The leg with the artificial joint has two wounds that have not healed and continue to bleed.
We have been applying medication, but there has been no improvement.
Should I consult the same doctor for further treatment, or should I seek another doctor? Should I make an appointment with an orthopedic surgeon or a general surgeon? Thank you.

Chenchen, 40~49 year old female. Ask Date: 2015/10/20

Dr. Wang Shouji reply Orthopedics

Hello: If there is a suspicion of infection, you should consult an orthopedic specialist first, rather than a general surgeon, because there is an artificial joint involved.
The orthopedic specialist will have a better understanding of how to treat this condition.
Thank you!

Reply Date: 2015/10/20

More Info

Hello! Thank you for reaching out with your concerns regarding your grandmother's ongoing issues after her joint replacement surgery. It sounds like she is experiencing complications that can occur post-operatively, particularly with wound healing. Here’s a comprehensive overview of what you might consider doing next.

First and foremost, it is essential to address the persistent wounds that are not healing and are continuing to bleed. This situation can be indicative of several underlying issues, such as infection, poor circulation, or even issues related to the materials used in the joint replacement. Given that these wounds have not improved over the past five years, it is crucial to seek professional medical advice.

1. Consulting the Original Surgeon: If your grandmother's original orthopedic surgeon is still practicing, it would be advisable to return to them for an evaluation. They are familiar with her medical history and the specifics of her surgery, which can be beneficial in diagnosing the problem. They may also be able to provide insights into whether the wounds are related to the joint replacement itself or if there are other factors at play.

2. Seeking a Second Opinion: If for any reason you feel uncomfortable returning to the original surgeon or if they are no longer available, seeking a second opinion from another orthopedic surgeon is a wise choice. When doing so, ensure that the new surgeon has experience with joint replacements and post-operative complications. They can provide a fresh perspective and may suggest different treatment options.

3. Specialist Referrals: Depending on the findings, it may be necessary to consult with other specialists. For example, if there is a suspicion of infection, a referral to an infectious disease specialist may be warranted. If circulation issues are suspected, a vascular surgeon might be involved.
4. Wound Care Management: In the meantime, proper wound care is critical. Ensure that the wounds are kept clean and dry, and follow any specific instructions given by healthcare professionals regarding dressing changes and medications. If there are signs of infection (increased redness, swelling, warmth, or discharge), it is essential to seek medical attention promptly.

5. Physical Examination and Imaging: The new physician may recommend imaging studies, such as X-rays or MRIs, to assess the condition of the joint and surrounding tissues. This can help determine if there are any complications related to the joint replacement itself, such as loosening of the implant or other structural issues.

6. Consideration of Surgical Options: If the wounds are due to complications from the joint replacement, the surgeon may discuss the possibility of surgical intervention to address the issue. This could involve debridement of the wound, revision surgery of the joint replacement, or other procedures aimed at improving healing.

7. Follow-Up Care: After any intervention, it is crucial to have a follow-up plan in place. Regular check-ups will help monitor the healing process and ensure that any new issues are addressed promptly.

In summary, it is essential to take your grandmother's ongoing wound issues seriously. Whether you choose to return to her original surgeon or seek a second opinion, timely medical evaluation and intervention are key to managing her complications effectively. Don't hesitate to advocate for her health and seek the necessary care to ensure her well-being. Thank you for your inquiry, and I wish your grandmother a swift recovery!

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