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If your Hip prosthetic has started causing you pain and stiffness, you should consult our expert orthopedic doctors for a revision Hip replacement surgery.
If your Hip prosthetic has started causing you pain and stiffness, you should ... Read More
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Dr DK Das - Pristyn care Ortho & Joint Care Centre
Delhi
Pristyn Care Clinic, Delhi
Normally, total hip replacement is one of the most successful surgeries in orthopedic medicine. In fact, after total hip replacement surgery, patients who cannot move before the surgery can start living a pain-free life and perform day-to-day functions that they could not before.
However, over time, parts of the hip implant can start wearing away. In such cases, the patient will once start experiencing hip pain and immobility. In these cases, the patient needs a revision total hip replacement surgery.
During revision total hip replacement surgery, the surgeon replaces all or part of the hip prosthesis with a new implant to relieve the patient’s pain and improve their joint function. It is a longer and more complex procedure than hip replacement surgery. In some cases, the surgeon may need to use specialized implants if there is extensive bone damage.
• Disease name
Osteoarthritis
• Surgery name
Revision Total Hip Replacement
• Duration
1 to 2 Hours
• Treated by
Orthopedic Surgeon
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Pristyn Care is one of the best orthopedic surgery providers in India. We have tie-ups with some of the best orthopedic hospitals in India to provide advanced treatment to patients across India. We have a team of expert orthopedic surgeons and doctors with over 8 years of experience to ensure successful patient recovery.
You can receive successful orthopedic surgeries, such as total hip replacement, revision hip replacement, partial hip replacement, hip resurfacing, etc., at Pristyn Care. To ensure a hassle-free treatment journey for all patients, we provide auxiliary services like insurance assistance, physiotherapy assistance, free follow-up consultations, complimentary cab and meal services, etc.
There are a few reasons for which revision hip replacement surgery can be recommended to the patient, such as:
During primary hip replacement surgery, the hip implant is firmly attached to the bones to ensure the proper functioning of the implant. This is done by either cementing the implant components to the bone or allowing the bone to grow around the implant.
However, sometimes the cemented connections loosen, or the bone fails to grow. In some patients, the overuse of the hip joint can lead to the wear of the plastic liner. Plastic liner wear can also occur due to an autoimmune response from the body.
In such cases, the implant will become loose and start causing symptoms similar to severe hip arthritis.
Infection in the tissues surrounding the implant during or after recovery is a serious issue that can necessitate revision hip replacement surgery. In some cases, it can occur immediately after the surgery, but in some cases, it happens years after the initial surgery.
In case of a hip replacement revision due to infection, the patient will need debridement of the implant to remove the infection, along with staged surgery to replace the implant. In staged surgery, the surgeon removes the implant and places a temporary spacer during the first surgery. The spacer is treated with antibiotics to help fight the infection. Once the infection is resolved, the spacer is removed, and the new implant is fixed.
The ball component of a total hip replacement implant is normally smaller than the natural joint. Therefore, it can easily get dislocated in case of trauma. Or awkward hip movements. Patients who have recurring hip dislocation after replacement surgery may need a specialized implant that is less prone to dislocation.
Trauma to the hip joint after hip replacement surgery can lead to a periprosthetic fracture, i.e., fracture of the bone supporting the implant. In some rare cases, the implant itself can also break.
In case of a bone break, the patient may not necessarily need revision surgery, but revision surgery is inevitable if the implant breaks.
Though metal implants are very resilient, over time, the metal components of the implant can start breaking down, leaching metal ions into the body. These ions can cause damage to the soft tissues surrounding the implant, necessitating surgery.
You should heed the following tips to prepare for revision hip replacement surgery:
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There are normally three parts of a total hip replacement implant – the acetabular component fixed in the hip bone socket, the femoral component, i.e., a femoral head that’s attached to the femur through the femoral stem, and a plastic liner that supports their junction.
Before the surgery, the surgeon will perform a thorough diagnosis to find out which component of the implant needs replacement. Diagnosis for revision hip replacement surgery is performed through medical and physical evaluation, followed by imaging tests like x-rays, MRI, CT scans, etc. In case of an infection or poor patient health condition, lab tests may also be performed.
The surgery is most commonly performed under general anesthesia, but in some cases, spinal, epidural, or regional anesthesia may be used based on the patient and surgeon’s preference. The procedure can be very complex and thus takes several hours.
During the surgery, the surgeon will make an incision to expose the joint. Then, they will examine the soft tissues surrounding the joint to look for damage or infection. Then, they will assess the implant for wear damage. After that, the damaged parts of the prosthesis will be removed while preserving as much bone as possible. Finally, the new prosthetic will be inserted in its place, and the incision will be closed.
After the surgery, you will be moved to a recovery room for postoperative observation. You may need to stay in the hospital for 1-2 days, depending on your health condition and the type of surgery. Some patients can even be discharged on the same day if there are no signs of complications.
You will have a little pain after the surgery, usually managed through medications like opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Pain management is essential during recovery to help the patient regain joint movement in a complete range of motion. Along with pain medication, antibiotics are also a must to prevent infection.
You should also begin physical therapy immediately to strengthen your joint and improve mobility. You may be susceptible to blood clot formation in deep veins, so you should also take blood thinners and wear compression stockings.
After your discharge, you should follow the given tips at your home to improve your recovery:
During primary hip replacement surgery, the surgeon only has to remove the part of the original joint and place the implant in its place. However, during a revision hip replacement surgery, the surgeon may have to remove the implant and parts of the remaining bone to place the new implant.
Therefore, the surgery is more extensive and requires more careful treatment planning. In some cases, the primary implants can even damage the soft tissues supporting the hip joint and implant, making the surgery even more difficult.
In cases with extensive bone and soft tissue damage, the surgeon needs to use specialized implants that compensate for the function of the damaged tissues.
Though revision hip replacement surgery, just like total hip replacement, is normally very safe, occasionally, there can be certain complications during or after the surgery.
The most common potential risks of revision hip replacement surgery are:
Contact your surgeon if you notice signs of infection such as increased redness, fever, swelling, pus drainage, etc.
A hip implant can easily last for more than 10-15 years without complications. Therefore, if there are no complications after your primary surgery, you won’t need revision surgery for at least 15 years.
Hip replacement revision surgery provides relief from hip pain and improves the mobility, strength, and range of motion of the hip joint in patients with hip joint dysfunction after total hip replacement surgery.
The overall duration of the recovery period can vary from patient to patient, but generally, patients can start walking without the support and resume their daily lives within 6 months of the surgery.
You should not drive for at least 8 weeks after the surgery, as car seats are compact, and you will put undue stress on the operated joint while driving.
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