Revision Hip Replacement Surgery
REVISION HIP REPLACEMENT SURGERY
Hip replacement is the most common surgery performed by the orthopaedic surgeons worldwide. Unfortunately inspite of being the most successful surgery, with every 10 years it has been documented that there is a decrease in the functioning of the implant due to various reasons. 10 years after a hip replacement, there is a 90% chance the implant will be functioning well, 20 years after surgery, and the chance is about 80%. By 25-30 years after surgery, about 50% of hip replacements are still working well. Those patients who wear out their prosthesis require a revision hip replacement surgery.
What is Revision Hip Replacement Surgery?
Revision Hip replacement is a surgical procedure in which a part or all of the previous hip replacement is revised. This can range from a small prosthetic implant replacement to total hip replacement.
This surgery is advised to patients with:
- Loosening of the joint: Aseptic loosening occurs when the hip implants become loose within the bone. This loosening usually tends to be painful, and requires revision hip replacement.
- Breaking of the bone around the prosthesis.
- Breaking of the prosthesis or plastic wear in which the plastic implant is changed.
- Dislocation of previous implants also requires a revision.
- Pain which may be due to various reasons.
- Infection in the joint replacement.
How do I prepare for the surgery?
It is necessary that you carefully plan the entire procedure with your orthopedic surgeon because:
- This procedure is a complex procedure and usually the result of the surgery is dependent upon the factors like The quality of the bone. Ability to adequately secure the revision hip replacements into position .Age of the patient and tolerance to long surgical procedures.
- This procedure as stated earlier is a complicated surgery and technically more complex as compared to primary hip replacement. As the patients usually have aged by the time they require a revision surgery, the effects on the patient are more significant (longer surgery, more blood loss).
- During these appointments, clinical tests including lab testing, urine analysis, EKG, and X-rays, will be conducted. Additional studies, such as bone scans, may also be recommended by your doctor.
What exactly is Hip Replacement surgery?
- Anatomy: The hip joint is located at the meeting point of the upper end of the femur, or thigh bone, and the pelvis, or the hip bone. There is a ball at the end of the femur, which is called the femoral head; it fits in a socket (acetabulum) in the pelvis. This ball allows a wide range of motion.
- Surgical procedure: Depending upon the extent and the correction required in some cases a mini-incision operation is not possible while some revision cases are relatively straightforward. It is dependent on the quality and quantity of the bone which is left behind after the implant has been removed and also on the difficulty level of the removal of the prosthesis.
- As compared to primary joint replacements the Revision joint replacements are much different. As there is almost always bone loss around the primary prosthesis, the surgeon places a bone graft or some other material around the artificial joint to reinforce the bone. Most likely, bone taken from your pelvis is used as the bone graft. The types of bone graft are:
- If it comes from your own body, during the same operation, it is commonly called an autograft.
- At times when a larger graft is required, your surgeon may choose to use bone graft from the bone bank. This type of bone graft which has been taken from someone else is called an allograft.
- If in the primary artificial joint cement has been used, this cement is removed from the socket of the hip as well as from the femoral canal. This may sometime lead to a fracture of the femur during the operation and your surgeon will also fix the femur during the operation. It is though not uncommon but renders the surgery its compound nature. In cases sometimes the femur is deliberately broken to take out all the cement.
- A new prosthesis is implanted, after bone and other materials have been applied to rebuild the socket and the femur.
Contraindications for this surgery:
- If your primary joint is not functioning well due to an infection that is uncontrollable,
- If the bone has been destroyed so much that it will not support an artificial joint
Non-tolerance to a major operation due to any medical condition like:
- dementia or other severe mental disorder
- severe vascular disease
- poor condition of the skin covering the hip
- extreme obesity
- paralysis of the quadriceps muscles
- terminal illness
How long will the surgery take?
- Pre – op: You will be admitted at least a day prior to the surgery.
- Operation: The duration of the replacement surgery will vary as mentioned earlier depending on the correction required. Most commonly this surgery is done under general anesthesia and as such time in the operation theatre may be more than three hours (because of anesthesia and preparation).
- Post – op: Post surgery, you will be moved into the recovery room to monitor your vitals as the surgery is done under anesthesia and this stay is for approximately two hours. As this surgery is more multifaceted and compound than the primary replacement the stay may be longer in the hospital
- Most patients are discharged after 4 to 5 days.
How long is the recovery following revision hip replacement surgery?
A period of adjustment is the primary requirement of Hip revision surgery.
- Physical therapy: physical therapy is started immediately after replacement surgery and continues throughout the hospitalization and at home for one year after surgery. The surgeon will tell you about limitations in movement required for better healing. You need to exercise your legs to reduce swelling, and elevate your legs above the heart when resting. After surgery, you will have to use a walker.
- After approximately a month, X-rays of the leg would be taken to monitor healing.
- After approximately six months, you should be able to walk without a limp, and without pain in the hip.
- After surgery, medicines or therapy would be prescribed by the surgeon to prevent blood clots.
You should ensure that there are family members to help you with your daily activities back home. What are the risks and complications of revision hip replacement surgery?
- Anesthesia associated complications may develop, such as respiratory or cardiac malfunction.
- Complications like infection, injury to nerves and blood vessels, fracture, weakness, stiffness or instability of the joint may also arise
What are the benefits of hip revision surgery?
- Relief from pain
- Improvement in mobility, strength and coordination of the upper body and leg.
- Improvement the appearance of the hip and leg.
- Ability to return once again to normal activity with a pain-free hip.
Success of a hip revision surgery is also subject to the patient’s assiduousness with his or her rehabilitation program following surgery.
Hip replacement is the most common orthopaedic surgery performed by the orthopaedic surgeons worldwide. Unfortunately inspite of being one of the most successful orthopaedic surgeries, some patients may require a redo or revision Hip Surgery. In many cases it is found that with every 10 years, there is a decrease in the functioning of the implant due to various reasons. 10 years after a hip replacement, there is a 90% chance the implant will be functioning well, 20 years after surgery, and the chance is about 80%. By 25-30 years after surgery, about 50% of hip replacements are still working well. Those patients, who wear out their prosthesis or the implant, require a revision hip replacement surgery. A Revision or a Redo Hip replacement is a surgical procedure in which a part or all of the previous hip replacement is revised. This can range from a small prosthetic implant replacement to total hip replacement.
A revision hip surgery is advised to patients who have any of the following conditions.
- Loosening of the joint. This loosening usually tends to be painful, and requires revision hip replacement.
- Breaking of the bone around the prosthesis.
- Breaking of the prosthesis or plastic wear in which the plastic implant is changed.
- Dislocation of previous implants also requires a revision.
- Severe pain which may be due to various reasons.
- Infection in the replaced hip joint.
The cost of revision Hip Surgery is very affordable in India and that is the reason why so many patients from different countries come to India for a revision hip surgery. The joint replacement surgeons in India are experts in revision or redo hip surgeries. Latest technology is used for diagnosing the problem and treating it.
How to Get Started ?
If you want to travel to India for high quality treatment and surgery then please send the following details to us by email at medical@treatmentassistance.in
- Name and age of the Patient
- Latest medical reports
- Details of current medical condition ( in brief )
For more information on traveling to India for medical treatment, you can write to us at medical@treatmentassistance.in or call or WhatsApp at +91 9900 244 323.