Revision hipprothesis

Complaints

Hip replacements are among the most common procedures performed by orthopedic surgeons in the Netherlands. The problem is that over time hip replacements wear out. Hip replacements can become necessary for a variety of reasons:

Luxation
Aseptic loosening; Aseptic loosening occurs when the hip implant become loose within the bone.
Wear of parts of the prosthesis
Breaking of the bone around the prosthesis
Infection; the hip replacement may need to be removed to treat the infection, followed by the revision hip replacement months later.

Treatment

The procedure of a Revision hip replacements is as follows:

The operation is performed under general anesthesia or spinal anesthesia
Once the worn-out prosthesis is removed first a culture detection method is used to exclude infection
Once the damaged bone has been removed, the artificial socket or acetabular cup can be inserted and with the bone prepared to accept the stem of the femoral component the femoral stem is inserted.
With the socket, stem, and ball inserted, the revision hip joint performance is examined and finally placed in position.
The wound is applied with a drain for excess of blood and/or fluid disposal, local anesthesia and closed with staples or dissolvable stitches.
The wound is wrapped with a bandage and inspected 2 days after surgery.

We use the latest techniques to minimize tissue damage so that recovery is progressing at a fast pace after surgery.

Preperation

How to prepare for your hip operation

You visit the anesthesiologist to determine whether the revision operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.
The day of surgery of is scheduled. The total hospital stay is planned for three days. You arrive on the day of surgery at the clinic. The days after surgery are used to recover and to receive instructions and exercise from the physical therapist.
You should borrow crutches as you will need them to walk following your surgery. For more information click www.thuiszorgwinkel.nl.
Usually it takes the two weeks to walk with a crutch at home. If you have lack of help at home please discuss this with the transfer nurse of the Vlietland hospital or home care setting of your home.

To undergo a revision hip replacement is not a daily matter. A hip replacement is major surgery with an extended recovery period. It is important to consider all consequences.

The better your physical condition before your treatment, the better your recovery after surgery.

Day of surgery

At your arrival please wear comfortable clothing and shoes. Bring your personal items such as medicines, clean clothes, toilet articles and your crutches with you. Leave valuables at home as much as possible.

Day of surgery

You appear sober at the hospital
After your medical preparation prior to surgery you will positioned and treated in the operating suite
After surgery you will be moved to the recovery room to recover from your anesthesia
Back on the ward the nurse checks you out. During the immediate recovery period you are given intravenous fluids and pain medication.

The day after your surgery, the physiotherapist will show you how to exercise and walking with crutches

Recovery

The recovery period after a revision hip replacement comprises three to six months. The days after surgery you are still hospitalized.

You get pain medication and you start physical therapy immediately with instructions for home practice. After two days, the wound dressing will be removed and the wound assessed.
After a few days the pain is usually bearable and pain medication will be reduced. Additionally, blood thinners will be prescribed to prevent thrombosis and pulmonary embolism.
Two weeks after surgery you use two crutches and while progressing in recovering occur you use one crutch, used on the unoperated side.
The stitches will be removed about 14 days after surgery
After surgery it takes at least 6 weeks before you may bend your hip joint more than 90 degrees, avoid any twist at the hip. Do not cross the operated lower extremity across the midline of the body (not crossing the leg over the other leg) because of the risk of dislocating of the replaced joint.
During the recovery process, you will return to a more active and normal lifestyle within a few months.
It is important to realize that you do not drive a car by yourself or ride a bike.

Complications

Although surgery is not without risks, complications may be related to anesthesia or infections. Consult your surgeon with the following complications:

Subsequent bleeding into the hip
The wounds remains sensitive long after surgery
There may be thrombosis or pulmonary embolism occurs.
Instability of the hip
The joint ‘clicks’ during movements
Dislocation of the replaced joint
The wound remains vulnerable sometimes long after the hip replacement.
There is a difference in leg length occurred or not corrected after getting a new hip
There is a pelvic instability created or after getting a hip replacement.
Infection of the hip prosthesis
Damage caused by the operation of structures around the hip, such as nerves or blood vessels

Sometimes the result of the hip prosthesis is not what you had hoped. There can be a painful sensation in the hip remain despite the hip prosthesis.

Note: In patients with a hip prosthesis infection elsewhere in the body pose a risk to the prosthesis. If you have an active infection in your body, please consult your specialist.

Expectations

You have high expectations of a revision hip replacement: a painless hip, which moves better than before the operation and no leg length difference. It is not guaranteed but usually the situation is much better after a replacement than before the operation. Nevertheless, you should realize that an operation is a risk of complications and needs an extensive recovery process. Your decision to choose for a total hip prosthesis must be well thought! However, most patients are extremely satisfied with their new hip.

Frequent asked questions (FAQ)

How long takes a revision of the hip replacement procedure?
The average duration of a hip replacement session is between 50 and 75 minutes.

How long will a hip replacement last?
Research shows that 80% stays longer than 20 years. Each individual has potential differences, especially in relative young patients and heavy use can shorten the lifecycle.

How old do I have a knee or hip replacement to get?
For people in "middle age" or older, a knee replacement is usually the best choice to relieve the pain of knee arthritis, and restore a reasonable level of function.

Will I ‘beep’ at an airport, with hip prosthesis, as I go through the gate?
Not common but especially in thin patients or multiple implants it can happen.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.