Here’s a thorough explanation for how a hip replacement surgery can lead to a stroke, described by an orthopedic surgeon.

Stroke is a real possibility soon following a hip replacement surgery, even if the operation is elective.

Stroke is the leading cause of disability in the U.S., and affects many people of middle age, not just over 65.

Though a person, prior to a hip replacement surgery, may already be at high risk for an ischemic stroke, the actual surgery itself can trigger events leading to the blood clot.

An ischemic stroke causes brain cells to quickly die, which is why every second counts when getting treatment.

An ischemic stroke results from a blood clot cutting off oxygen to the part of the brain that the blood vessel feeds. Shutterstock/solar22

“Hip replacement, in and of itself, does not cause a stroke, like it can cause an infection or a leg length discrepancy,” says Barbara Bergin, MD, board certified orthopedic surgeon at and co-founder of Texas Orthopedics, Sports & Rehabilitation Associates.

“Like any stressful event to an aging human body — death of a loved one, losing a job or running a marathon — a total hip replacement is a stressor.

“You lose blood. You might lie in bed more than usual. You set in motion some of the factors which could contribute to heart attacks and blood clots.

“Certainly, if you had a stroke a week after a total hip replacement, you could say it might be related to the stress of the surgery, but you couldn’t say it was caused by the operation itself.

“It was probably caused by a plaque which was present in the carotid artery, and that happened to be the day it busted free and went to your brain.

“So, more importantly, as people age they become more susceptible to strokes.

“People don’t actually need a stressor to suffer a stroke. It can happen on a sunny, happy day, while you are playing bridge with your friends. It can happen while you sleep.

“But it can also happen following a hip replacement.”

How common does a stroke occur soon after hip replacement surgery?

Less than two percent of hip replacement patients actually experience complications, which include joint infection, heart attack and of course, ischemic stroke.

Dr. Bergin says, “I would not even name a stroke in my list of potential risks and complications of surgery when getting medical consent from a patient.

“I’m sure it’s listed on that long list of things on the official consent form, but you might be almost as likely to have a stroke the day before surgery, as the day after. It happens.”

The most common complications are blood clots forming in the veins of the legs or pelvis. These are called deep vein thromboses.

These cannot travel to the brain, but they can travel to the lungs and be fatal.

Every year in the United States, over 193,000 total hip replacement surgeries are performed, one of the most amazing marvels of modern medicine.

But the unsettling news is that every year in the U.S., over 700,000 people suffer a stroke.

Dr. Bergin is a general orthopedist, surgically and conservatively treating all manner of bone and joint conditions. She enjoys educating patients so they can emerge stronger than they were before their orthopedic injury or surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Top image: Shutterstock/HENADZI PECHAN