Institute Of

Orthopaedics

Revision Hip Surgery

Avoiding infections is crucial in surgical operation. In some cases, even a grume accumulation has to be removed to avoid secondary infections. In some cases, it’s a usual practice to open the surgery area and wash it, the method of wound irrigation. Mostly in rare cases like unpredicted either unfortunate incidence goes wrong. Emendation surgery is not the fate accompli, but an inevitable element over years.

Currently available literature says 95% of implants stay for over 20 years. But post that you might need replacement, because of the subsequent reasons: Loosening, infection, wearing of the bone, unforeseen pain, Dislocation or Fracture of bone supporting prosthesis.
Loosening of the portion (the cup or the stem) is one reason for the hip to become painful in the prolong. This is called aseptic loosening. This may occur due to deboning of the cement in cemented hip replacements, wear of the polyethylene, portion subsidence and migration, injuries or fractures around the replaced joint. The constant fretting of this loose portion against the bone leads erosion of the bone and bone loss.
Preoperative X-ray showing eccentric femoral head because of poly wear and aseptic loosening of femoral stem
Postoperative X-ray showing revision acetabular shell and Wagner revision stem
Revision surgery of the hip involves removal of these loose elements, cleanup the bone cavity and replaces the joint with new elements. Significant loss of bone generally makes these surgeries complicated and requires alternate techniques. These procedures would require correct coming up with, applicable choice of elements and methods to revive the bone loss. The trendy materials, standard elements, bone substitutes and new strategies enable the surgeon to offer customised successful options. These are dependent to the particular problems associated with the case. There has been a relentless modification and evolution within the varied surgical techniques and choices.

Almost all revision surgeries nowadays are addressed to with non cemented fixation of elements. The surface of those implants allows bone in-growth on to the surface, so creating the element fixation solid, stable and close to permanent.

At the Asian Joint Reconstruction Institute (AJRI) situations involving significant bone loss and alternative complexities bear a method of precise coming up with newly acquired 3D swift prototyping. This enables exact mapping of the location of component placement, the need for any additional material like augments or bone graft to cover defects. This has enabled precise reconstruction of the hip joints with smart predictable functional outcome.

Hip Revision Surgery for Infection

Preoperative X ray showing acetabular erosion and septic loosened femoral monoblock stem
ALCS – Antibiotic Loaded Cement Spacer made out of mould
Hand made ALCS with Shanz pin in situ
Postoperative X ray with revision acetabular cup and Revision Wagner stem

Hip Revision Surgery for Dislocation

Preoperative X-ray showing dislocated hip with femoral stem subsidence
Postoperative X-ray with retained acetabular socket and a long revision Wagner stem