Revision Hip Replacement Surgery Florida

Revision hip replacement surgery is when more surgery is needed on a hip joint that already has a total hip implanted. Typically, a “revision” hip replacement surgery is a more complex procedure requiring more time, expertise and special equipment. The potential complications associated with revision surgery also tend to be greater. Removing the old prosthesis can be destructive and often requires a more extensive incision and dissection. Fortunately, we now have more specialized instruments and modular prosthetic hip implant systems which are specifically designed for complex re-do surgeries with major bone deficiency. These have vastly improved our ability to reconstruct the hip and still achieve an excellent result.

There are multiple reasons why a person who already has a total hip, would require more surgery. One of the most common reasons is instability. The prosthetic ball dislocates from its intended position in the socket. Critical to reconstructing a stable hip with equal leg lengths is implanting the cup and stem in an optimal position. In my experience, the PAL (visit the Video Gallery to view the PAL video) has been essential in my ability to accomplish this consistently. The size of the femoral head, which is typically being implanted today compared to just several years ago, is larger. Larger femoral heads are more stable than smaller ones. This has been possible because on a molecular level, the quality of the plastic bearing surface has been improved. By increasing the polyethylene cross-links while eliminating oxygen free radicals, the bearing surface is made much more resistant to wear. Alternate bearing surfaces have also been developed including those made of ceramics and metal. In spite of the strategies that have been developed in recent years, instability is still a major reason why some total hips need revision.

Another common reason for revision surgery can be attributed to the bone that is supporting the prosthesis becoming deficient or absent. This can lead to the loosening or instability of components. After millions of cycles and years of use, the prosthetic ball wears into the socket. Tiny particles of debris are produced which incites an inflammatory process and stimulates the resorption of the bone that supports the implants. This condition is called osteolysis. It remains one of the biggest problems with any joint replacement in the body. Better quality plastics and alternate bearing surfaces have been developed with the hope of diminishing osteolysis. Other reasons for revision include fracture around the prosthesis or of the prosthesis, infection, and leg length inequality.

 

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