Revision Hip & Knee Joint Replacements
Although, Hip and Knee replacements are quite successful operations, there are complications that can happen and the joints may fail due to various reasons.
If this happens, you may need a revision operation in which part or whole of the old prosthesis (artificial joint) is taken out and replaced with a new one. This is called a Revision Hip/Knee Replacement. Although primary and revision joint replacement have the same goal of improving function and relieving pain, revision operations are more complex. It needs extensive planning, use of specialized implants and instruments to achieve a desirable result.
When do you need a revision operation for a replaced joint?
Implant Loosening:
A joint replacement functions properly if its fixed to the bone securely either with the help of bone cement (Cemented joint replacement) or when the bone grows around the implant and hold its firmly (Uncemented Joint Replacement). Either of them will gradually loosen over time or loosen due to mechanical failure of fixation. This causes pain and eventually will need a revision operation to change the implants.
Infection:
Infection post a joint replacement is disastrous complication and may lead to failure of joint replacement. Infection gradually loosens the implants off bone and also lead to pain or pus discharge. As the bacteria reside on the implant surface, it can not be eradicated without removal of implants. Depending on what type of bacteria or infection is present, there are various operations to get rid of infection such as debridement, DAIR procedure and ultimately removal of implants and putting new implants after a period of antibiotic therapy.
Your surgeon will discuss these treatments depending on case-to-case basis.
Dislocation/Instability:
A joint replacement needs to be stable for it to function properly. A hip replacement can dislocate if its loose, or at extremes of movement or not done properly at first place. A Knee replacement is unstable due to ligament failure or rupture. Depending on the reason and chances of improvement, your surgeon will discuss revision operation in these scenarios.
Fractures:
The bone around the replaced joint can fracture following a fall after the operation. Many factors may need to be considered during revision surgery in this scenario such as the implant fixation to the bone, health of the remaining bone and location of fracture.
Other factors:
There are other factors such as stiffness, metal allergy, quadriceps dysfunction, unexplained pain that can lead to joint failure and eventually revision if appropriate. Visit us to know more.
My Experience with Revision Hip & Knee Replacement:
Revision joint replacements are challenging operations. During my training years I developed special interest in Revision Arthroplasty. I did get specific training for these skillful operations at Robert Jones and Agnes Hunt Orthopaedic Hospital, UK and National Orthopaedic Hospital, Dublin. During my fellowship years I had the opportunity of operating complex revision cases under the guidance of the esteemed specialists in that field.
