Hip and knee replacement surgery is among the most successful and predictable operations in all of medicine but hip replacement surgery isn’t foolproof. And when the procedure fails, who or what is at fault?
Dislocation of the implant is the most common cause for hip-replacement failure, followed by infections, a loosening of the implant, polyethylene wear, and surgical technique.
The frequency of hip replacement is increasing dramatically because of
an aging population, people having it done at a younger age, and new and improved technology and techniques allowing long-term survivorship.
Instability or dislocation of the initial hip device accounts for approximately 23 percent of revisions. Mechanical loosening of the device causes nearly 20 percent of the revisions, and another 15 percent may be attributed to infection. Patient satisfaction following revision surgery is much less than that following the initial procedure.
With the bone destruction from a loose or infected prosthesis or polyethylene wear (osteolysis) and/or the bone destruction associated with removal of a failed prosthesis, the patient has a much higher risk of a permanent limp. Additionally, there is a greater need for a permanent cane or pain relieving medication when contrasted to the predictable outcome of a primary hip replacement.
Technique is more important than the prosthesis itself. It’s something that those of us who do a lot of hip and knee replacements have known for quite a while.
As a patient, you should be concerned most with the surgeon who is doing the replacement; not the length of the incision or the number of nights in a hospital. While the latter two patient concerns need be respected, the absence of short term or more chronic complications and long term survivorship with maximum satisfaction must take precedence.
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Hip and knee replacement surgery is among the most successful and predictable operations in all of medicine but hip replacement surgery isn’t foolproof. And when the procedure fails, who or what is at fault?
Dislocation of the implant is the most common cause for hip-replacement failure, followed by infections, a loosening of the implant, polyethylene wear, and surgical technique.
The frequency of hip replacement is increasing dramatically because of
an aging population, people having it done at a younger age, and new and improved technology and techniques allowing long-term survivorship.
Instability or dislocation of the initial hip device accounts for approximately 23 percent of revisions. Mechanical loosening of the device causes nearly 20 percent of the revisions, and another 15 percent may be attributed to infection. Patient satisfaction following revision surgery is much less than that following the initial procedure.
With the bone destruction from a loose or infected prosthesis or polyethylene wear (osteolysis) and/or the bone destruction associated with removal of a failed prosthesis, the patient has a much higher risk of a permanent limp. Additionally, there is a greater need for a permanent cane or pain relieving medication when contrasted to the predictable outcome of a primary hip replacement.
Technique is more important than the prosthesis itself. It’s something that those of us who do a lot of hip and knee replacements have known for quite a while.
As a patient, you should be concerned most with the surgeon who is doing the replacement; not the length of the incision or the number of nights in a hospital. While the latter two patient concerns need be respected, the absence of short term or more chronic complications and long term survivorship with maximum satisfaction must take precedence.
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