What Patients Need to Know About
Revision Surgery After Hip or Knee Replacement
Hundreds of thousands of hip and
knee replacement surgeries are performed in the United States each year, and
they are highly successful in eliminating pain, restoring mobility and
improving quality of life.
"Joint replacement, in which
an orthopedic surgeon replaces the arthritic areas of a joint with a metal,
plastic or ceramic implant, has given countless people a new lease on
life," says Dr. Geoffrey Westrich, an orthopedic surgeon and Director of
Research, Adult Reconstruction and Joint Replacement Service at Hospital for Special
Surgery in New York City.
The implants used in joint
replacement generally last 10 to 15 years, although some newer prostheses may
last up to 20 years. Sometimes, a revision surgery is needed sooner, though,
and Dr. Westrich says the main reasons include:
•
Loosening of the
implant. The hip or knee replacement may become painful after many years
because the components have begun to wear and loosen.
•
A fracture. A fall or
severe blow can cause a fracture of the bone near the hip or knee replacement.
•
Dislocation. If the
implant dislocates on repeated occasions, revision surgery is frequently needed
to stop this from happening.
•
Infection. This can be
a very serious complication. If a deep infection develops in a hip or knee
replacement, revision is often needed to eradicate the infection and to implant
new non-infected components.
•
Implant recall. On
occasion, the implant used in joint replacement is found to have a problem and
patients who received the implant are advised to be monitored by their
physician to make sure it does not need replacement. Revision surgery is
sometimes necessary when an implant is recalled.
Dr. Westrich says patients should
be aware of warning signs that there may be a problem, such as pain that comes
on suddenly or trouble getting around. They also may have decreased range of
motion. Anyone with a joint replacement experiencing these symptoms should see
their doctor immediately, Dr. Westrich adds.
A revision joint replacement is
much more complicated than the initial operation and many physicians who
perform primary joint replacements will refer their patients to an expert in
revision surgery. "Because of the complexity of revision hip and knee
replacement, a certain amount of skill and experience are required," notes
Dr. Westrich, who has had patients referred to him from around the country.
"If someone needs a revision
surgery because of an infection or other issue, it is critical to find an
orthopedic surgeon who performs many of these operations, preferably at a
hospital such as Hospital for Special Surgery, which is an orthopedic specialty
hospital and joint replacement center."
Patients often ask Dr. Westrich if
there are steps they can take to make their initial hip or knee replacement
last longer. Dr Westrich says a number of factors are within a patient's
control to increase longevity and avoid the problems requiring a revision:
• Avoid overusing the joint. Patients are advised to avoid
high impact activities, such as running and singles tennis, which can shorten
the lifespan of the joint replacement. Walking for exercise is better than
running; opt for doubles instead of singles tennis.
• Avoid sports in which jumping and landing hard can damage
or weaken the joint, and engage in nonimpact activities that build muscle
strength.
• Maintain a healthy weight. Being overweight, especially
obese, is a main factor in developing arthritis in the first place. People who
are overweight are more likely to experience loosening of an implant.
• Once the initial healing has taken place and discomfort
has diminished, see your orthopedic surgeon if pain develops suddenly.
• If you develop a bacterial infection in another part of
your body after joint replacement, be sure to see your medical doctor for
appropriate antibiotics.
• Pay a visit to your orthopedic surgeon every few years
after hip or knee replacement, even if the joint feels good. The physician can
check for early loosening of the implant or another minor problem before it
causes a major headache, such as dislocation.
• Have your primary hip or knee replacement with an
experienced surgeon who specializes in the procedure and at a center that
performs a high number of joint replacements to ensure the best outcome and
lower the risk of complications.
Story Source:
The above story is based on materials provided by Hospital for Special Surgery, via
Newswise.
Note: Materials may be edited
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