Revision Joint Replacement Case Study

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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 joint replacement? A. Yes, apart from implant wear, the major indications for revision joint replacements are infection, fracture around the implants, gross instability or dislocation. One or more of these factors may make the original construct non-viable even if the implants themselves are not worn out. In-fact, in most patients, more than one…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

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