No one who has had a joint replacement procedure wants to hear that they need another procedure on the same joint. But despite the success rate of this type of surgery, the fact remains that some people will need to have a joint revision procedure at some point in their lives.
Joint revision surgery is used to correct a problem with an implanted artificial joint after primary joint replacement (also known as arthroplasty). Since more people have artificial knees than any other joint, the number of revision knee procedures performed by orthopedic surgeons like me is higher after primary knee arthroplasty than other large joints, such as the hip and shoulder.
If you’re thinking it might be time for joint revision surgery, here’s all you need to know.
Common reasons for joint revision
There are a few common reasons that you would need a revision after primary joint replacement. Depending on the reason, a repeat or redo operation may be required in the short, intermediate or long run.
- Surgical wound problems: Primary joint replacement is an invasive procedure. If there is an issue with the wound—particularly a problem with drainage—in the days and weeks following the operation, an infection in the implanted joint can occur that may require a revision to correct.
- General infection: Infections can impact any part of the body. Patients who are susceptible to infection (often due to other health issues) sometimes have infections that attack the implanted joint. In fact, infections are the most frequent reason for needing joint revision.
- Loosening of the prothesis: On occasion, an artificial joint can loosen from the underlying bone. This can cause complications that often need to be addressed by a revision procedure.
Avoiding the need for joint revision
Most the work to reduce the risk of needing a joint revision procedure should happen before ever having a primary joint replacement.
There are known risks that increase a person’s chances of having a complication following a joint replacement. Some of these, like obesity, smoking status, diabetes control and narcotic use, are at least somewhat modifiable, meaning you can improve them by making lifestyle changes. Optimizing these factors prior to surgery has the advantage of improving your chances of success.
Finding your right fit
Joint revision procedures are typically more challenging than the primary replacement procedure. They are more time and resource intensive and also carry an increased risk of complications. That’s why it is important to find an orthopedic surgeon who makes these procedures a focus of his or her practice.
Equally as important, since most joint revisions do not need to be performed on an emergency basis, take time to find a surgeon you are comfortable with who wants you to be a part of the decision-making process. In fact, that’s sound advice not just for finding an orthopedic surgeon, but anyone with whom you are trusting something so sacred: your health.
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