Hip Replacements Can Fail
According to a study by researchers at the Agency for Healthcare Quality and Research and the Food and Drug Administration, about 200,000 total hip replacements, 100,000 partial hip replacements, and 36,000 revision (repeat) hip replacements were performed in the United States in 2003. The relatively high number of hip replacements needing revision has prompted other researchers from the University of California, San Francisco, to look into why hip replacements fail.
Reasons for Hip Revision
Bearing surface wear was thought to be the reason behind most hip revisions. But other problems can occur and may even be more common reasons for hip revision. Over the years, hip implant design and surgical technique have undergone changes in order to create more stable hip prostheses that last longer.
Researchers found that the most common reasons for hip revision include:
- implant dislocation
- implant loosening
- infection
These findings suggest that the design of the prosthesis is not the sole concern. Surgical technique and the way the implant is placed can also be problematic.
Patients who don't follow post-operative protocol and stick to restrictions that are part of their rehab can cause problems for themselves. The restrictions are essential for preventing dislocation and loosening of the joint prosthesis.
Results of the Study
According to the study, revision of all components of the hip -- acetabular (socket) and femoral (thigh bone) components -- is most often due to instabilty or dislocation, followed by mechanical loosening, and infection.
For the acetabular component of the hip (also referred to as the cup), instability or dislocation were the most common reasons for revision.
For femoral component revision, mechanical loosening was the main indication. Infection was the reason for removal of the prosthesis in nearly 75% of cases.
Tips for Avoiding Hip Revision
You can take measures to decrease your chance of needing a revision:
- Find a surgeon with a flawless reputation.
- Find a hospital that is Joint Commission Accredited or Certified.
- Ask your surgeon about his revision rate.
- Learn all you can about what's expected of you before, during, and after hip replacement surgery. Follow the advice to the letter.
- It is your responsibility to follow hip replacement precautions after surgery. And don't even think about cheating.
- At any time after hip replacement surgery, if you feel pain or discomfort, have it checked out.
- Avoid slips and falls which could result in dislocation of the hip prosthesis.
If you and your doctor give the surgery your best effort, it should be a long time before you're faced with hip revision.
Sources:
The Journal of Bone and Joint Surgery. Bozic KJ et al. The epidemiology of revision total hip arthroplasty in the United States. 2009.
http://www.ejbjs.org/cgi/content/abstract/91/1/128
Replacing Your Total Hip Replacement. AAOS. 1/2/2009.
http://www6.aaos.org/news/Pemr/releases/release.cfm?releasenum=734
