Revision Joint Replacement Case Study
Q. What do you mean by “Revision” Joint Replacement?
A. Primary joint replacements may wear out or fail over a period of time which may range from a few years up to two or three decades. Revision joint replacement is the term given to the process of removing primary prosthesis from a failed artificial joint, reconstruction of the pathological condition and implanting new prosthesis to restore normal joint mechanics.
Q. Why do original implants wear out?
A. The main reasons for implant wear are mal-alignment (less than ideal alignment), poor soft tissue balancing, instability and natural wear at the bearing surface (the surface at which motion occurs) over the years.
Q. Apart from implant wear, are there any other issues necessitating revision …show more content…
The first and foremost challenge is identifying the cause of failure of the primary joint replacement. This requires meticulous clinical examination and a series of investigations. Once the cause is identified, elaborate preoperative planning is required to avoid any surprises during the surgery. The surgical procedure is extensive and requires an expert surgical team, special equipments and implants, and the support of a good anaesthesia team. The reconstruction of bone loss and deficiencies requires an allograft bone bank which provides a biological answer to bone loss. A well established allograft bone bank is being run at Primus according to the guidelines of American Association of Bone Banking. The bones harvested from living donors at the time of primary joint replacement are screened thoroughly and preserved and used for revision joint replacements whenever …show more content…
Firstly, primary joint replacements should be performed only by those surgeons who have acquired adequate training in this field and a major proportion of whose practice constitutes joint replacement only. Great care has to be exercised to ensure proper alignment, perfect soft tissue balancing and durable implant fixation in order to prevent premature failure. The implant and the bearing surface have to be carefully chosen according to the patient’s age, bone quality, severity of the preoperative condition, activity demands and social needs. The use of computer aided navigation has enabled us to avoid human errors and thus, provide the ideal alignment and soft tissue balancing at the time of primary joint replacement. We believe, this would go a long way in reducing the revision rate in the future.
Q. Is there any role of computer aided navigation in performing revision joint replacement surgery?
A. Currently, we are using the navigation protocols for primary joint replacements to perform revisions also (with some modifications in the technique). Intensive research is on and very soon, dedicated software for performing revision joint replacement with computer aided navigation will be in place.
Q. What is your advice to patients who have undergone primary joint
A. Primary joint replacements may wear out or fail over a period of time which may range from a few years up to two or three decades. Revision joint replacement is the term given to the process of removing primary prosthesis from a failed artificial joint, reconstruction of the pathological condition and implanting new prosthesis to restore normal joint mechanics.
Q. Why do original implants wear out?
A. The main reasons for implant wear are mal-alignment (less than ideal alignment), poor soft tissue balancing, instability and natural wear at the bearing surface (the surface at which motion occurs) over the years.
Q. Apart from implant wear, are there any other issues necessitating revision …show more content…
The first and foremost challenge is identifying the cause of failure of the primary joint replacement. This requires meticulous clinical examination and a series of investigations. Once the cause is identified, elaborate preoperative planning is required to avoid any surprises during the surgery. The surgical procedure is extensive and requires an expert surgical team, special equipments and implants, and the support of a good anaesthesia team. The reconstruction of bone loss and deficiencies requires an allograft bone bank which provides a biological answer to bone loss. A well established allograft bone bank is being run at Primus according to the guidelines of American Association of Bone Banking. The bones harvested from living donors at the time of primary joint replacement are screened thoroughly and preserved and used for revision joint replacements whenever …show more content…
Firstly, primary joint replacements should be performed only by those surgeons who have acquired adequate training in this field and a major proportion of whose practice constitutes joint replacement only. Great care has to be exercised to ensure proper alignment, perfect soft tissue balancing and durable implant fixation in order to prevent premature failure. The implant and the bearing surface have to be carefully chosen according to the patient’s age, bone quality, severity of the preoperative condition, activity demands and social needs. The use of computer aided navigation has enabled us to avoid human errors and thus, provide the ideal alignment and soft tissue balancing at the time of primary joint replacement. We believe, this would go a long way in reducing the revision rate in the future.
Q. Is there any role of computer aided navigation in performing revision joint replacement surgery?
A. Currently, we are using the navigation protocols for primary joint replacements to perform revisions also (with some modifications in the technique). Intensive research is on and very soon, dedicated software for performing revision joint replacement with computer aided navigation will be in place.
Q. What is your advice to patients who have undergone primary joint