Answers to Your Questions about Hip and Knee Revision Surgery
You’ve already undergone joint replacement surgery, and now you may have some questions: Will the prosthesis last? How long should it last? What are the signs that tell you it’s time to replace the prosthesis? Find answers to these and many other questions in this Q&A on hip and knee revision surgery.
Q: How long does an artificial joint last?
A: The lifespan of the prosthesis depends on its usage, the patient’s age, whether the patient has properly cared for the prosthesis, as well as the surgeon’s expertise — all play a vital role in how long the prosthesis will last. Luckily, nowadays the lifespans of prostheses
are much longer than before, with more that 90% lasting 10–20 years.
Q: Why is surgery sometimes required to repair an implanted prosthesis?
A: There are many possible issues and scenarios that can make surgery necessary to repair an implanted prosthesis. The four main reasons are:
Q: What symptoms indicate there may be a problem with an artificial joint?
- Loosening of the joint after a long period of use
- Infectious arthritis (infection of a joint)
- Bone fracture around an artificial joint
- Dislocation from the original position; this happens more frequently with hip replacements than with knee replacements
A: Some patients may not show any symptoms at all, and symptoms may vary from person to person. But most patients will likely experience the following symptoms:
Q: How do doctors determine whether a patient needs to undergo surgery to repair an implanted prosthesis?
- Pain in the area of the prosthesis
- Swelling in the area of the prosthesis
- Limited mobility
- Feeling unstable or having difficulty maintaining balance
- Skin inflammation
A: The doctor may utilize the following methods to confirm a diagnosis:
Q: How long does the surgery to repair an implant take?
- Physical examination
- Analysis of lab test results
- CT scan
- Magnetic resonance imaging (MRI)
A: Surgery duration depends on the complexity of the issue and the procedure chosen to make the repair. In most cases, surgery may take at least twice as long as the first arthroplasty procedure; surgery can take at least 2–3 hours, but even longer in more complex cases.
Q: How can the need for repair surgery for new implants be avoided?
A: Patients are advised to do the following:
- Strictly follow the doctor’s instructions on proper post-surgery care of the joint
- Get proper exercise to keep joints healthy
- Keep track of symptoms and inform the doctor immediately of any problems that arise
- Avoid activities that put heavy pressure on the joints, such as walking up and down the stairs
- Do not participate in high-impact sports such as running and jumping, which bring too much impact on the joints, and avoid carrying heavy objects
- Make sure to control body weight and choose exercises such as swimming or cycling that are low in joint impact
Additionally, watch for infections and take antibiotics as prescribed by the doctor. In the event of tooth decay infections, urinary tract infections, skin infections, or lung infections, see the doctor urgently in order to prevent the infection from spreading to the prosthesis.
Q: How long can the repaired joint implant be used for?
A: The repaired joint can typically be used for about as long as the original joint implant. But depending on the complexity, the lifespan of the repaired joint may not be as long as the original joint implant and may also have reduced performance due to scar tissue formation or fibrosis.
Q: How many times can patients undergo surgery to repair a prosthesis?
A: There is no set number of times a patient can undergo surgery to repair an implant; however, scar tissue around the muscles will continue to build up with each treatment, making mobility more and more difficult.
Q: How long will it take to recover after revision surgery?
A: Recovery time for each patient varies. Some patients recover faster than their first arthroplasty, while for others, the reverse is true. In cases where an infection occurs, recovery is usually much longer, generally taking at least 6 months.
Q: How does the surgical space suit that surgeons wear during surgery help protect patients from infection?
A: The surgical space suit consists of both a head cover and a robe made from special materials designed to prevent contamination from the surgeon’s saliva, breathing, and sweat, which in turn reduces the risk of infection.
Q: What precautions do doctors take to reduce the risk of post-operative infection in patients?
A: In addition to the surgical space suit worn during the surgical procedure, there are a number of protocols in place to reduce infection risk, including:
Q: How does the surgeon protect a patient from deep vein thrombosis (DVT)?
- Following strict sterilization protocols that meet international standards
- Using antibiotic prophylaxis
- Using sutures or other wound-closing devices that have an antibacterial coating
A: Unfortunately, deep vein thrombosis
in the legs does occur in a small number of cases of joint revision surgery; however, the surgeon will do the following to reduce the risk of occurrence:
Q: When can the stitches be removed?
- Doctors may prescribe medications to help prevent DVT; the doctor will make sure the medications are safe and appropriate for each individual patient
- Doctors may provide compression stockings which will give support to the legs and increase blood circulation, which helps prevent blood clots
- Medical staff may perform intermittent pneumatic compression to help with blood circulation.
A: When the wound is completely healed, which generally is about two weeks after surgery. Doctors nowadays will almost always use dissolvable stitches or skin glue, where stitch removal is not required; if non-dissolvable stitches are used and removal is required, they can be removed after 14 days.
Q: When will you be able to return to normal activities after revision surgery?
A: The timeframe for being able to return to normal activities is different for each patient:
- Patients are generally able to drive at 4–6 weeks post-surgery; however, the doctor should confirm when the patient is able to get back behind the wheel.
Note: For driving automatic transmission vehicles, surgery on the left knee enables patients to get back to driving sooner than after surgery on the right knee
Q: Does a patient who has already undergone artificial joint replacement surgery still need to take glucosamine for revision surgery?
- Some patients are able to resume sexual activity fairly quickly, while others may have to wait up to 6–12 weeks
- Low-intensity sports can usually resume 3 months post-surgery; the wound must be completely healed before resuming swimming activities
A: There is no benefit from taking glucosamine
for someone who has already gone through joint replacement surgery. It is always a good idea to consult your doctor before taking any new medications or making changes to existing medications.
Q: What are the benefits of having surgery to repair a prosthetic implant?
A: Patients are able to regain use of their damaged joints, freeing up mobility, and thus improving their quality of life.
By the Joint Replacement Center at Bumrungrad International Hospital