Hip Replacement Surgery
For people suffering with intense pain and limited mobility from hips damaged by arthritis, hip replacement surgery can seem like a miracle. Although it is miraculous, hip replacement is not always a permanent solution.
People who have their first hip replacement when they are in their sixties or older are likely to live the rest of their lives without needing revision of their hip replacement. However, younger patients are more likely to need revision surgery at some point. Wear of the materials and loosening of the implant are the most common reasons for needing revision surgery.
Hip implants are designed to replicate the ball and socket structure of the normal hip in human anatomy. The hip implant consists of a component which fits into the pelvic socket or acetabulum, commonly a metal cup with a plastic polyethylene lining, and a metal ball on a long stem which fits into the thigh bone or femur.
As normal wear occurs, the friction caused by the metal ball rubbing against the polyethylene plastic lining can result in the degradation of the polyethylene and the flaking off of the small polyethylene particles. The body's immune system reacts to the particles as foreign matter and attacks it. Since the particles typically settle near the implant, the immune system also attacks surrounding bone, a process known as osteolysis. As bone loss occurs, the hip implant can loosen and begin to function improperly.
Osteolysis is regarded by many orthopedic surgeons as the number one cause of hip implant failure. Other causes include incomplete fixation and infection.
Revision Hip Replacement Surgery
When implant failure occurs patients must have another surgery to replace the failed implant, known as revision hip replacement surgery. Since valuable bone can be lost when an implant fails, revision surgery is more complicated than the primary or original hip replacement.
Though the procedure for revision hip replacement is similar to primary joint replacement, there are some differences:
Since revision surgery is regarded as more difficult, it is imperative to have an experienced surgeon and seasoned surgical team. A properly equipped hospital ready for any situation is a consideration as well. New implants such as metal-on-metal and ceramic-on-ceramic are being tried now with the hope that they will prove to be more durable. It still will take one or two decades before that durability can be truly assessed.
Carol's Hip Replacement Diary: Pre-Op and Post-Op Thoughts
Pre-op and post-op thoughts of your About.com Guide to Arthritis, Carol Eustice as she goes through a revision hip replacement.
Related Resources - Hip Replacements
Sources: Arthritis of the Hip & Knee, Ronald J. Allen, Victoria Anne Brander, M.D., S. David Stulberg, M.D.; About Total Hip Replacement, Sulzer Orthopedics