Avoiding infections is essential in surgical procedure. In some cases, even a blood clot accumulation needs to be removed to avoid secondary infections. In some cases, it is a normal practice to open the surgery area and wash it, the process of wound irrigation. This is done as an unforeseen, unfortunate incidence when something goes wrong. Revision surgery is not the fate accompli, but an inevitable element over years.
Currently available literature says 95% of implants stay for over 20 years. But post that you might need replacement, due to the following reasons: Loosening, infection, wearing of the bone, unforeseen pain, Dislocation or Fracture of bone supporting prosthesis.
Loosening of the component (the cup or the stem) is one reason for the hip to become painful in the longterm. This is called aseptic loosening. This can occur due to debonding of the cement in cemented hip replacements, wear of the polyethylene, component subsidence and migration, injuries or fractures around the replaced joint. The constant fretting of these loose components against the bone results in erosion of the bone and bone loss.
Revision surgery of the hip involves removal of these loose components, cleaning the bone cavity and replace the joint with new components. Significant loss of bone sometimes makes these surgeries complex and calls for alternate techniques. These procedures will require proper planning, appropriate selection of components and strategies to restore the bone loss. The modern materials, modular components, bone substitutes and new strategies enable the surgeon to offer customised successful options. These are dependent on the specific issues related to the case. There has been a constant change and evolution in the various surgical techniques and options.
Almost all revision surgeries today are addressed to with non cemented fixation of components. The surface of these implants enables bone in-growth on to the surface, thus making the component fixation solid, stable and near permanent.
At the Asian Joint Reconstruction Institute (AJRI) situations involving significant bone loss and other complexities undergo a process of precise planning with the newly acquired 3D rapid prototyping. This enables exact mapping of the location of component placement, the need for any additional material like augments or bone graft to cover defects. This has enabled precise reconstruction of the hip joints with good predictable functional outcome.
At AJRI there are specialists and sub-specialists. Hence, a wide range of solutions is offered.
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