Revision of hip replacement is done for the patients, immediately or after many years of the hip replacement surgery, due to various implications or wear out. Sometimes the failure of the replacement procedure also leads to the revision of the same procedure.
The reasons for the revision of hip replacement are many. The following are the typical conditions of the revision of the hip replacement.
- Component Failure
- The implant
The slight shift of the hip implant after the surgery leads to the weight distribution to be unbalanced and cause the premature failure of the implant. The typical reason for such failure is because of the plastic insert wearing down in the hip socket. It may happen immediately or after a few years. These implants daily activities done every day usually produce around 2 million cycles per year. For this component failure, the revision of hip replacement is performed, either replacing the plastic wear alone or the entire implant, in case the metal is also affected from it.
The dislocation may happen due to various reasons over the hip bone, after the hip replacement surgery and felt by the patient. In all these cases, the revision is necessary. The implant can be corrected to locate in its place, without the need of the surgery, however, sometimes, the total replacement of the implant would be needed and the decision would be taken by the surgeon.
In case the bone that is nearby the implant gets fractured by an accident or some other reasons, revision surgery is performed. The original implant is needed to be removed and the revision joint will be implanted.
The quality of the implant is majorly dependent on the material used for the implant. It is important to discuss, what kind of material is used for the implant, with the surgeon as well as why that material is preferred by the surgeon. Whatever the material is used for the implant, it should have good smoothness, resistance to scratching and also abrasion and the hardness. Oxinium is usually a strong and quality material used for the implant by many of the surgeons.
Though it is rare, there are evident cases, where the hip gets infected to some extent after the surgery is performed. In most of the cases, it can be treated successfully with the help of the antibiotics, but in a few percentage of the cases, revision surgery follow up would be needed. When the revision surgery is performed, the primary implant is removed even temporarily and new implant called spacers, which are antibiotic-laced are then implanted. These spacers allow certain amount of time to heal the infection before the new revision surgery takes place. During this period, usually of 6 weeks, antibiotics are given to the candidate to heal the infection. The follow up evaluations done by the surgeon would determine when the body would be ready for the revision and will be performed accordingly.
When the plastic components in the implant get worn down, the side effects will be started. Very fine and tiny particles of plastic that is worn down are attacked by the immune system of the body. The same immune response would also affect the healthy bone, present at the surroundings of the implant. Orthopaedist usually checks this by X ray and determine the need for revision of the hip replacement surgery.
The revision of the hip replacement surgery involves four parts that help restoring the original function of the implant or ball and socket joint.
- A hip stem made of metal inserted at the thighbone at its top
- A metal cup that is used to hold the cup liner
- A cup liner that helps the femoral head to be held
- The ball or femoral head that gets attached to hip stem at its top, which is inserted in the liner that together forms the ball and socket joint
The size of the hip implant is not same the same for all the candidates. Unique and right size of the implant should be chosen, according to the size of the hip of the candidate. The four design options are determined by the surgeon based on the suitability. When the right size of the implant is used, it gives accurate length and the premature implant wear and post-operative dislocation probability would be minimized.
Cost of Revision of Hip Replacement Surgery
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