Revision of knee or hip prosthetics

What is prosthetic revision? 

Artificial knees and hips have a limited lifespan and usually need to be revised in order to prevent complications arising. This is what is meant by prosthesis revision.

There are three main parameters that influence the lifespan of a prosthesis: 
•    the quality of the materials
•    the quality of the implant placement 
•    how active the patient is and the stress the implant will be subjected to over the course of the patient’s life. 

Taking all of this into account, current estimates for the lifespan of an implant stand between 15 and 20 years on average.

Which patients is this suitable for?

There is no such thing as a wear-free prosthetic. Like any mechanical item, prosthetics will wear as you use them, whether in the knee or the hip. Generally speaking, the younger the patient, the more physically active they will be and, in turn, the more mechanical stress the implant will be subjected to, which risks compromising its lifespan day after day. 

What are the symptoms? 

There are two major complications that may occur: 
•    complications relating to infections, if the implant is contaminated by a microbe or a germ, which will lead to loosening 
•    mechanical complications, which include fixation failure, instability or even progressive loss of mobility accompanied by stiffness.

If any of the warning signs below are experienced, immediate consultation with a specialist will be required:

•    pain 
•    difficulties or discomfort completing everyday movements
•    a feeling of instability
•    a dislocation or even recurring dislocations
•    unusual noises coming from the implant.

The specialist will perform a clinical assessment and imaging to identify the cause of the symptoms, which may eventually lead to a prosthetic revision.

Continuing to use a faulty prosthetic may be dangerous, as it may lead to complications, with a risk of damaging and weakening the surrounding bone structures, but also a risk of weakening the fixation of the implants on the bone, and sometimes even of the implant itself fracturing. Complications like this make treatment more complex, and may compromise the patient’s ability to walk. This is why it’s important to monitor implants.

What treatments are available?

Thanks to technological advancements and the introduction of highly wear-resistant materials (such as ceramics), modern artificial joints can now remain in place for an average of 20 years, sometimes more. In the past, they usually had to be changed after 10 years. 

Today, prosthetics are no longer made from one-piece parts, known as monoblocks, but from modular parts, i.e. an assembly consisting of several components, which means only the worn parts need to be replaced. Whether you are replacing the entire old prosthetic with a new one or only certain parts, this is referred to as a ‘revision’. 

Therapy

The revision is a delicate operation which needs to be performed by an experienced surgeon. Artificial knee or hip implants remain a well standardized procedure for which the execution and duration of the various stages are predictable. If a revision is required, the length of the procedure is often more difficult to predict and may last several hours, depending on the difficulties encountered in extracting the implants in place, and according to the local conditions for implanting the new prosthetic. Indeed, bone reconstructions are sometimes necessary.

Postoperative follow-up / Medical follow-up

Recovery after a revision often takes longer than following the initial surgery, as it is sometimes more invasive and rehabilitation may be required. It is not always immediately possible for the patient to put their full weight on the prosthetic following surgery. Whereas the patient is usually able to put their full weight on the leg that has been operated on (using crutches) right from the outset following initial knee or hip surgery, this is not always the case with a revision. If the revision procedure caused the bone structures to weaken, the patient will need to keep their weight off the leg concerned, either partially or totally, for a certain amount of time. 

Why have a prosthetic replaced with Swiss Medical Network? 

Swiss Medical Network has the very best specialists in orthopaedic surgery and traumatology, particularly including doctors that specialise in prosthetic revisions. Our centres are also equipped with cutting-edge technical facilities and technological advances are now opening up the possibility of multiple revisions over the course of the prosthetic’s lifespan, while ensuring satisfactory functional results.