Revision Orthopedic Implant Surgery

Revision Orthopedic Implant Surgery is a risk associated with joint replacement surgery. This includes: Hip Replacement Revision Surgery, Knee Revision Surgery, Wrist Revision Surgery and Ankle Revision Surgery. There are several reasons why an implant may fail or need to be replaced, such as  those linked to the Metal Hip Implant Recall. It’s important to have a Q and A session with your orthopedic surgeon to be fully educated about Revision Surgery. There may be a need to perform revision orthopedic surgery in your lifetime, depending on your age, implant failure risks, or due to health risks associated with defective implants. 

167926376Metal Hip Implant Recall Alert and Revision Hip Surgery

If you have a Metal Hip Implant, your primary care physician, orthopedic surgeon, and/or revision hip replacement specialist  will help you identify if your hip implant was involved in a recall; learn what you need to do to reduce the risk of complications, such as monitoring “metal levels” in your body; and identify candidacy for Revision Hip Replacement Surgery if necessary.

Hip Revision Surgery or Knee Revision Surgery

For individuals who underwent a Hip Replacement or Knee Replacement Procedure and qualify, a revision surgery may be required in select conditions, as follows.

  • Loosening of implants.
  • Dislocation of the implants.
  • Instability of the implant.
  • Wear in some parts of the implant over time.
  • Breakage of the implant.
  • Fracture of the bone around the implant.
  • Implant has worn out.
  • Infection.
  • Defective implant that poses health risks.
  • Other Factors, such as Obesity, poor compliance to rehabilitation program, compromised blood supply, development of adverse reaction to implants.

Hip Replacement Revision Surgery: The Procedure

During the Hip Revision Surgery, a part of the whole implant components or the entire implant is removed using extraction techniques, such as the use of osteotomes instrument or the ultrasonic cement removal system.  The socket is the cleaned and a new lining in the acetabulum may be placed using porous metals, such as tantalum or titanium.  In general, a longer or larger femoral implant may be used as the femoral area may be more shortened during the procedure.  Bone grafts, cements and screws may be used to stabilize and strengthen the implant.  For metal-to-metal replacement implants, highly cross-linked polyethylene or ceramic revision prosthesis may be used.

There are two types of revision prosthesis that may be used, as follows.

  • Cemented prosthesis uses a type of epoxy cement that would attach the metal implant to the bone.
  • Uncemented prosthesis has fine holes where bony ingrowths can project, attaching the prosthesis to the bone.

Knee Revision Surgery: The Procedure

In case of implant failure, a knee revision surgery may be required.  For this surgery, various revision techniques may be employed, as follows.

  • Use of revision prosthesis with stems or wedges.
  • Rebuilding of the joint and use of special revision prosthesis, such as the hinged implants.
  • Use of metal cages.
  • Use of cement to strengthen and stabilize revision implants.
  • Replacement of damaged ligaments.
  • Use of bone grafts to fill the defects.
  • Use of metallic augments or extensions.

Ankle Revision Surgery: The Reasons and  Procedure

When the ankle replacement implant is not sufficiently fixed to the bone, the implant may loosen, break or dislocate.  Infection, meniscus wear and tear, unstable artificial joint, bone impingement, cystic deformities and bone fractures are also the reasons why an ankle revision surgery may be required.

Ankle Revision Surgery is still quite new in the field of orthopedic surgery. Thus, new techniques are still being developed.  Nevertheless, special revision implant, such as the three-component ankle prosthesis is already available.  Bone graft made up of mesenchymal stem cells may also be used to encourage bone formation around the implant, stabilizing the revision prosthesis.

Shoulder Revision Surgery: The Reasons and The Procedure

Loosening, wear and tear, dislocation and breakage of implants are some of the reasons why shoulder revision may be needed.  Another reason for a shoulder revision surgery would be infection. 

For Infection Related Shoulder Revision Surgery,  an antibiotic spacer is placed prior to the reconstruction with the new (revision) implant. 

Wrist Revision Surgery: The Reasons and The Procedure  

Wrist pain, infection and damage, loosening, wear and tear, instability or dislocation of the implant may necessitate wrist revision surgery. 

Several Techniques are used for wrist revision, depending on the condition.

  • Simple as debridement.
  • Arthroscopic shortening of the ulnar bone.
  • Capsular shrinkage.
  • Scaphoid reduction.
  • Percutaneous pinning.
  • Repair of prosthesis.
  •  Part or total revision prosthesis.

Revision Surgery Complexity Risks

167926376Greater Complexity

Longer Surgical Duration 

Longer Recovery Potential

Longer Rehabilitation Time Period 

Increased Overall Risks

Stabilization of the implant may pose a challenge because more supporting bone tissues may be required to remove.  With joint replacement, scar tissue may develop and the soft-tissue in the area of the implant may not be recognizable anymore, making the procedure more complex and more difficult to perform. There are a select number of orthopedic surgeons that may focus their practice  on revision orthopedic surgery and may be more familiar with advanced expertise in managing through more complex surgeries. Researching information  about orthopedic specialists, choosing quality care,  and having a thorough Q and A session with your orthopedic surgeon may be beneficial in advance of selecting your orthopedic surgeon and having revision surgery.

It is important to recognize that medications and medical procedures are associated with benefits and risks that should be discussed with your physician. It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition. Your Health Access disclaims any liability for the decisions you make based on this information.