Revision Joint Replacement Surgery
Hip and knee replacements are very successful operations transforming the lives of many people.
Just like any medical treatment, they sometimes fail, and further treatment may be required.
When such treatment involves surgery, it is called “Revision hip or knee replacement”.
Reasons for failure in Hip Replacements
Aseptic loosening
This is loosening of one or both of the implants. It usually takes many years to develop but can rarely be an early mode of failure.
Dislocation
Dislocation occurs when the ball part of the hip replacement comes out of the socket part.
Infection
Deep seated infection occurs in under 1% of hip replacements. It can occur both early, or later as a complication of infection elsewhere in the body.
Fracture
fractures around the hip replacement can very rarely occur during surgery. These can often be treated during the operation without compromising the eventual outcome. They can also occur many years after the hip replacement.
Mechanical disturbance
Issues with the soft tissues or muscles around the hip can occasionally lead to pain that can be difficult to diagnose.
Leg length difference
Reasons for failure in Hip Replacements
Aseptic loosening
Infection
Pain and stiffness
Malalignment
Occurs when one or both components are placed in the wrong position resulting in pain, stiffness and other problems such as instability.
Reasons for failure in Knee Replacements
Expert assessment and investigation of the failed joint replacement is essential in successfully treating failed joint replacements. This is best done by an experienced surgeon who has an interest in revision surgery.
Assessment involves establishing the history of the failed joint replacement and a thorough examination. An X-ray is essential and more complex investigations, such as a CT scan or an MRI scan, may be required.
If infection is suspected further invasive tests may also be required to identify the bugs that may be present in the joint.
This is essential in determining the types of antibiotics that may be required as a part of the treatment.
Crucial to treatment of failed joint replacements is a Multidisciplinary Team (MDT) approach to assessment, planning and treatment. The MDT team involves other surgeons (including plastic surgeons), microbiologists, radiologists, specialist nurses and other allied professionals.
Mr Veysi has a large revision surgery practice at Chapel Allerton Hospital where he leads the West Yorkshire revision MDT and network. In the last 3 years he has carried out nearly 150 revision knee replacements (national average is 14). He has full access to the MDT for patients he sees in the private hospitals.