Why is a revision arthroplasty required?
- Pain is the primary reason for revision. Usually the cause is clear but not always.
- Plastic (polyethylene) wear .This is one of the easier revisions where only the plastic insert is changed.
- Instability which means the joint is not stable and may be giving way or not feel safe when you walk
- Loosening of one of the joint components. This usually presents as pain but may be asymptomatic. It is for this reason why you must have your joint followed up for life as there can be changes on X-ray that may indicate that a revision arthroplasty.
- Infection-usually presents as pain but may present as swelling or an acute fever.
- Osteolysis (bone loss). This can occur due to particles being released into the joint which result in bone being destroyed
- Stiffness-this is difficult to improve with revision but can be helped with the right indications.
It will be explained to you prior to surgery what is likely to be done but in revision surgery the unexpected can happen and good planning can prevent most potential problems. The surgery is often, but not always, more extensive than your previous surgery and the complications similar but more frequent than the first operation.
The surgery varies from a simple liner exchange to changing one or all of the components. Extra bone (cadaver bone) may need to be used to make up for any bone loss.
Remember this is an artificial implant and must be treated with care.
Avoid the complex movement as this can cause dislocation. If you have increasing redness or swelling in the wound or temperatures over 100.5° F you should call your doctor.
Risks and complications
As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. Some of the complications include infection, dislocation, injury to blood vessels, blood clots, limb length inequality, failure to relieve pain, unsightly or thickened scar, pressure or bed sores and limp due to muscle weakness.
Post-surgery rehabilitation is essential to avoid further complications such as reduction in the range of motion, muscle weakness and recurrence. Physical therapy may be initiated immediately after surgery and may be continued for up to three months. Physical therapy includes uses of crutches or walker along with strengthening and mobilization exercises to regain the strength and mobility of the joint.