Revision Total Hip Arthroplasty

Feature Summary

        Our team is composed of highly experienced surgeons to make correct diagnosis and deal with an unsuccessful hip arthroplasty surgery. Common problems included recurrent dislocation, infection, loosened implant, impingement or persistent hip pain with causes to be determined. The goal of a revision total hip arthroplasty surgery would be to create a stable, painless, well-functioning hip joint that is free from infection.

Overview

       Recurrent pain, swelling and disability of a hip joint after a total hip arthroplasty surgery is problematic. Common causes are listed as below:

  • Infection

        Clinical presentations of an infected hip joint include pain, swelling, erythematous skin, purulent discharge and local heat. Proper assessment, diagnosis, and management of periprosthetic joint infection (PJI) is the key to eradicate infection.

  • Instability

        Patients may have recurrent dislocation with a certain posture that makes patients unable to walk or adapt to his/her daily activity well. In most of the cases, an experienced surgeon can put the implant, including the cup and stem in a good position. Therefore, we don’t usually limit the postures of the patients following a hip arthroplasty surgery.

  • Wear or implant loosening (without signs of infection, aseptic)

        Longevity of the prosthesis depends largely on patients’ age and activity level. Wear or implant loosening may happen many years after primary total hip  arthroplasty surgery, with presentation of painful sensation over a previously well-functioning, painless joint. X-ray is the main diagnostic image modality of this condition.

  • Persistent “Painful” total hip arthroplasty with unknown causes

        A hip operated with total hip arthroplasty should be painless, able to bear weight and to do range of motion without difficulty. A “painful” total hip arthroplasty should be carefully assessed for signs of infection, instability or loosening. In addition, other possible causes including impingement, metal particles related inflammatory response or excessive leg length discrepancy should as well be considered. A thorough history taking, physical examination and image study by a highly experienced surgeon is the key to solve a “painful total hip arthroplasty”.

 

Procedures and Features

        Our team is composed of experienced orthopedic doctors, infectious disease specialist and radiologists who can make accurate diagnosis and management of a painful, malfunctioning hip joint following total hip arthroplasty surgery.

        We have set up one of the largest bonk bank in Taiwan, which makes us easy to deal with different degrees of bone loss during a difficult revision surgery.

        Operation time largely depends on surgical plan, which may vary from about 1 to 4 hours. Not all the components should be removed and replaced during a revision surgery. Instead, we would revise only the problematic components and aim to make the revision surgery effective and easy.

        Muscle training and weight-bearing program will be decided by orthopedic doctors according to intra-operative findings. In most revision surgeries, protective, partial weight-bearing program would be suggested for approximately 6 weeks for a solid bony integration onto the implant surface. Patients would be allowed to walk without weight-bearing restrictions thereafter.

 

Estimated cost

        The procedure cost is around 700,000 NTD, depends on the actual medical expenses.