It is widely known that knee and hip replacement surgeries nowadays can have highly favourable outcomes. Knee and hip replacements can change one's life highly positively when the operation is performed properly.
With proper care, a replacement joint would normally last 15-plus years. However, for reasons such as diminished stability, reduced function, increased pain, joint infection and bone fracture, patients may need a revision of their joint replacement.
A joint revision operation is actually more complicated and difficult to deal with than the original replacement. It requires pre-operative planning, specialised tools, and considerable surgical skills to perform the procedure successfully. Don't be too scared to revise your joint though, since it is still very possible.
Dr Siripong Ratanachai, director of Bumrungrad Joint Replacement Center, explained why joint revision surgery is more complicated than initial surgery and disclosed the possible complications.
"Today, about 20% of joint replacement patients from the former generation return for a revision. This is because the original artificial joint has reached the end of its lifespan. If the previous operation wasn't completely accurate, some artificial joints can deteriorate at a faster pace than usual.
"Patients usually notice some indicators when a knee or hip implant needs to be replaced. These include instability that makes the patient trip or fall more frequently than usual. There may also be new or worsened pain which, in turn, may lead to increased reliance on pain killer medication.
"Revision procedures are typically more complicated than first-time replacements. This can be because of scar tissue formation, loss of normal bone or difficulty in removing fixed implants, all of which can diminish surgical performance. Moreover, revisions are susceptible to complications.
"Complications from joint revision surgery can include infection in the new implant, deep vein thrombosis, dislocation of the new implant, bone fracture during or after the operation, and joint stiffness.
"After the surgery, the patient will most likely stay in hospital for several days. Pain relievers, blood-thinning medications and antibiotics are normally prescribed to relieve the pain and prevent blood clot and infection. Physical therapy is also important to increase strength, mobility and improve ability to do daily activities.
"The recovery time for knee or hip revision surgery depends on the reason for the revision. If the revision is a simple surgical procedure to replace a worn out bearing surface, for instance, the recovery time will not be lengthy. However, if the revision is for a more major issue such as infection or fracture, the period of recovery may last six to 12 months.
"More importantly, patients undergoing knee or hip replacement revision surgery should see their doctor at least once a year, even if they're not experiencing any problem. It is always much better to check for early loosening of the implant or any other minor problem before it becomes a larger problem. If a patient is experiencing pain, instability or another issue with their new joint, we recommend that they make an appointment to consult their doctor immediately.
"To ensure that an artificial joint lasts to the end of its lifespan, patients should stay in good health and exercise properly in order to keep surrounding bones firmly attached to the artificial joint. In addition, patients should avoid extreme postures that might damage the artificial joint. They should also avoid injuries to the joint because although the risk of breaking a bone is the same, it is more difficult to fix a broken bone with an artificial joint than a broken bone with a regular joint. Patients should also avoid drinking alcohol. Although there is no direct effect of alcohol on artificial joints, the reduced consciousness can result in patients losing balance and getting injured that way.
"Joint revision operations always have favourable outcomes provided there is sound operative planning, the right specialised tools, skilled surgeons and anaesthesiologists, and highly-experienced postoperative care teams including rehabilitation personnel and physical therapists.
"Many patients find that joint replacement revision surgery can give them their lives back. After the operation, they can perform their daily activities without pain or instability again. It's like getting another chance to live a normal life."
