As people live longer and more people receive joint replacements at younger ages, it is expected that an increasing number of those implants will wear out and / or fail for some reason. In these cases a second operation will be necessary to replace or revise the failed first replacement and this procedure is referred to as revision joint replacement. The increasing demands placed on these implants by patients in terms of longevity and durability; and expectations of patients to maintain their active lifestyles even with a joint replacement has presented a considerable reconstructive challenge to the surgeon.
Fortunately, despite the complexity for the surgeon and the prolonged rehabilitation for the patient -- if the underlying cause for the failure of a joint replacement can be determined and a well thought out plan is executed well, a satisfactory outcome for revision joint replacement can be as high, with up to 90% of patients having a good to excellent result. It is important to have an experienced surgeon and support staff to take on the difficulties inherent to this type of surgery in order to improve the chances of achieving this high rate of success.
Revision Total Knee Replacement
Revision total knee replacement surgery is becoming a more needed solution to the pain of a failing joint replacement. Most pain in a well done knee replacement does not constitute the need for a revision and can be handled by more conservative measures. It should be noted that many orthopaedic surgeons will not even attempt the challenging surgery associated with revision total knee replacement, as it is technically demanding and carries a higher risk of complication or failure than does a first time joint replacement.
Even with the most successful primary total knee replacements, there may come a time when a patient requires knee revision surgery. Current estimates indicate approximately 10% of joint replacement surgery done annually is to revise part or all of a previously done knee replacement. The most common reasons for failure and subsequent revision are for pain from an implant that has loosened from the supporting bone, for instability problems or for the devastating development of an infection in the artificial joint. In all cases the affected implant will be removed and a new, more complex implant will be needed to solve the problem.
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Revision Total Hip Replacement
Revision total hip replacement surgery is a complex procedure and in general, a surgeon will consider revision hip surgery for pain relief only when more conservative measures, such as medication and changes in the patient's lifestyle, have not helped. There are many reasons why a hip replacement fails and the complexity of these failures can be a challenge for the average surgeon to sort through. Most orthopaedic surgeons will not even attempt the technically challenging revision of a failed hip replacement. But Dr. Zehr is experienced and skilled in these complex joint revision surgeries and is well prepared to assess and successfully revise even the most difficult among them.
Keep in mind that even with the most successful primary total hip replacements, there may come a time when a patient requires a revision of the primary total hip surgery. The most common reason for the revision of a total hip replacement is loosening of the stem on the femoral (thigh bone) or acetabular (cup or socket) side. This can occur with or without infection. The surgeon removes the old implant and replaces it with a new one.
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