Revision total surgery is a procedure who has already undergone joint replacement surgery but has had some complications in the previous surgery. Revision joint replacement is far more complex surgery than the initial surgery. Revision joint surgery requires a lot of pre-planning, specialized tools and implements, different complex surgical techniques. The implants used are supposed to stay for a longer period of time. However some may remain for a longer time, some may deteriorate with the wear and tear.
Revision of the joint replacement means to remove or revise all the previous implants. The operation involves very minor adjustments to very complex surgery such as replacing considerable amount of bone.
Indications:
- Persistent pain
- Wear and tear of implants
- Instability
- Loosening of prosthesis
- Infections
- Weakening of surrounding bone
- Stiffness
Revision Total Joint Replacement:
A simple problem may involve the replacement of the plastic liner. A complex problem may be an infection requiring the removal of the knee prosthesis, the placement of an antibiotic spacer, and six to eight weeks of intravenous antibiotic therapy to eliminate the infection before re-implanting prosthesis.??The first step is removal of the implant. If there has been significant bone loss, bone grafts may be required to fill the spaces. Bone grafts can be either auto graft (your own bone taken from another site of your body) or an allograft (bone tissue from another person obtained from a bone bank). In some cases, metal wedges, wires or screws may be used to strengthen the bone. Finally, specialized revision knee implants are implanted. Temporary drains are usually placed to collect any fluids or blood that may remain after surgery.
Risks and complications:
Any surgery can have possible complications. The intricacy of revision joint surgery increases the chance of surgical complications. Possible complications include:
??Infection
??Bleeding
??Damage to nerves or blood vessels
??Intra-operative fractures
??Blood clots
??PE (Pulmonary Embolism)
Infection, bleeding, damage to nerves or blood vessels, and intra-operative fractures can be minimized by using antibiotics before and after surgery, sterile surgical techniques and utilizing well-planned surgical exposures. Mild swelling of the knee or ankle may be present after surgery for as long as three to six months. Swelling can be treated by elevating the leg, applying an ice pack, and wearing compression stockings. The decision to perform revision joint surgery is made when the benefits of pain relief and functional improvement balance the risk of potential problems.
