ARTHRITIS OF THE HIP JOINT

Cemented hip replacements may fail after 10 to 15 years, or occasionally sooner. The parts may come loose or wear out, or they may break. In some patients with cementless implants, the porous surfaces may not bond properly to the bone. Loose, worn or broken parts may need to be replaced (“revision surgery”).

It involves longer operating time and increased blood loss, and may require an increase in the length of the hospital stay. A mini-incision operation is not possible for revision surgery, even though some revision cases are relatively straightforward. Much depends on how difficult it is to remove the prosthesis, and on the quality and quantity of bone left behind after the implant has been removed. The trochanter bone may need to be cut to remove the implant. Wires may be needed to hold the parts together until the bone has healed. Bone grafts from your pelvis and/or from a bone bank may be needed if defects need to be filled with bone. With bank bone, infections can be transmitted in the same way as with blood transfusions (see Disease Transmission Through Blood Transfusion).

There is a chance that your leg may be shorter or longer than it was before the operation. The femur bone can be fractured during surgery, requiring extra repair procedures. The range of motion may be less than after first-time hip replacements. There is a high risk of dislocation for 12 weeks after revision hip surgery, and restrictions must be continued for at least that long to prevent dislocation. Patients who have revision operations are frequently advised to use a cane full-time, in order to protect the replacement from re-loosening.

Arthritis of the Hip Joint copyright © 2005 Herbert D. Huddleston, MD.
Arthritis of the Knee Joint copyright © 2005 Herbert D. Huddleston, M.D.

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