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If complications from a hip replacement procedure persist, or your implant fails, corrective surgery may be necessary to make the hip stable again. This may include tightening the muscles and ligaments in the area. In some cases it may require replacing the entire device.
Metal-on-metal hip implants are more prone to this than other types of hip replacement. This has led to recalls of some models.
If you are exhibiting symptoms that may be caused by problems with your replacement hip, a series of tests will help determine if the implant is failing for any reason. X-rays are useful for detecting bone loss and implant wear and tear. Comparison to previous X-ray results can often determine whether an implant has failed due to loosening. For this reason, regular follow-up radiography is often recommended after a hip implant procedure, so potential problems can be identified early.
A complete blood count, erythrocyte sedimentation rate (ESR), and a C-reactive protein test (CRP) can all help determine if infection is present. Doctors may remove joint fluid for analysis or perform a variety of imaging tests.
Hip Revision Surgery Procedure
A revision surgery procedure will vary depending on a variety of factors, including what complications the surgery is meant to address, whether the entire implant needs to be replaced, and the condition of the remaining bone. It is more complex than the initial replacement procedure, and has a higher risk of side effects.
Patients undergoing revision surgery will often require blood donation prior to the surgery to account for the more extensive dissection that the procedure requires. The incision may utilize the scar from the initial hip replacement but is generally larger to simplify implant removal and replacement. Scar tissue will often need to be removed as well.
If some parts of the implant are still functioning properly, the surgeon may choose to leave them in place.
During the procedure, the surgeon may use several methods to remove the implant, including specialized cutting tools or surgically splitting the femur to facilitate component removal. The method used depends on a variety of factors. If some parts of the implant are still functioning properly, the surgeon may choose to leave them in place.
In cases involving significant osteolysis, bone reconstruction may be needed before a new implant can be placed. This can be achieved through bone grafts, through the addition of artificial components such as metallic plates, or through a combination of the two.
Implants used for revision surgeries may be larger than those used for a first replacement to compensate for bone loss. In particular, the femoral stem is often longer.
Repetitive Dislocation and Hip Revision Surgery
Patients who dislocate their hip implant are at risk of repetitive dislocations, because the initial dislocation can distort the musculature around the joint. Patients who are very old, or who had their hip replaced after a fracture, are also more prone to this complication.
The surgeon has several options to prevent further dislocations. They may adjust the components of the implant, replace one or more components, or utilize a device known as a constrained socket that helps hold the implant ball in place.