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Revision Total Hip Replacement Surgery
- Days In Hospital 5 days
- Outside Hospital Stay 7 days
- Success Rate 78%
Minimum Cost
$ 5000
Maximum Cost.
$ 8000
Overview of Revision Total Hip Replacement Surgery in India
Hip revision surgery is the procedure that repairs or a replaces an artificial hip joint. You may need this procedure after a hip replacement surgery to address damage to your artificial hip including:
- Normal wear and tear,
- Loosening of the implant from the bone,
- Dislocation (popping out),
- An infection,
- A broken bone around the prosthetic (artificial hip joint),
- Alignment problems.
Damage to your artificial hip joint can lead to symptoms of pain and discomfort that affects the way you use your hip. The goal of hip revision surgery is to improve the function of your hip.
Revision of total hip replacement is required in the following circumstances:
Loosening of the implant: Over time, the components of the knee implant may loosen which can lead to pain and unstable movements. A revision is required to repair, and/or reinstall the implant in a stable manner.
Wear and Tear: The prosthetic components may wear out from over time. This can lead to pain and loss of functional we can help with a revision to replace these parts that may be wearing out.
Infection: There can be infections in the joint and or surrounding tissues that could effect how the implant works. In cases of revision surgery, the infected tissue will be adequately cleaned and or the entire implant will be revisited.
Instability: In some cases, the knee joint may become unstable based on the design of the implant and it's placement. An revision will assist with the alignment and stability.
Bone Loss: The amount of bone loss surrounding the implant can limit the support of the implant and its function. A revision may also take more special implants and/or techniques to address the bone loss.
Types of Revision Total Hip Replacement Surgery:
Component Replacement
In a revision like this only one component of the hip prosthesis is replaced while the other components are left intact. For example, if the cup or socket is causing problems, it is removed and a new cup socket is implanted while the femoral stem remains unchanged.
Stem Replacement
When the femoral stem when it causes issues it can be changed. This is done by removing the femoral stem and putting in a new one that is the best fit for each particular patient's condition.
Cup Replacement
This type of revision is used if the cup socket is loose or unstable or any other number of problems arise. The damaged cup is removed and a new cup is implanted. It takes special skills and tools to perform this type of procedure.
Entire Revision
At times, the stems of the femoral component and the cup may need to be completely replaced due to serious bone loss, fracture, secondary embedded debris, infection or looseness of the prosthesis (or potentially other issues). An entire revision involves removal of the entire existing hip prosthesis (both femoral component and cup) and implantation of an entirely new prosthesis.
Complicated Revision
In some cases the surgery for revision is going to be difficult. There may be autologous bone grafting, debridement or repairs of bone defects or abnormal soft tissue elevations, and sometimes, custom, or complex interchangeable implants may be necessary to tackle the issues of extreme bone loss complications or deformities of local soft tissue.
Procedure:
Medical Evaluation
You will be asked to schedule a complete physical examination with your primary care doctor a few weeks before the revision surgery. This will ensure that you are healthy enough to have the surgery and complete the recovery process.
Patients with chronic medical problems, such as heart disease, may also need evaluation by a specialist (i.e. cardiologist) prior to surgery.
Tests
Imaging tests. Your doctor will typically request imaging tests to get a better picture of your hip's condition. This could involve:
X-rays. X-rays give photographs of dense structures, like bone. Your doctor may require X-rays of the joint replacement to look for loosening or a change in positions of components.
Other imaging tests. A nuclear medicine bone scan may see if the prosthesis has become loose from the bone. There are times that a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan could assist to determine why your hip has failed and the condition of the bone.
Laboratory tests. Your doctor may request blood tests to assist in determining if you have an infection or have a reaction to the metal components of your hip. The doctor also may aspirate your hip. In this procedure, the joint fluid is removed using a needle and syringe, and then sent to a laboratory for analysis to see if an infection is present.
Home Planning
Your mobility will be limited for several weeks after your surgery, so if you live alone, you will likely need some help with cooking, shopping, bathing, and laundry. You can make arrangements in advance for someone to assist you at home through your physician's office, a social worker, or a discharge planner at the hospital.
Depending on your medical condition, you may need to reside at a nursing facility or rehabilitation centre for a period of time after your discharge from the hospital. If necessary, your healthcare team can also help you arrange a short stay at an extended care facility during your recovery.
Procedure of Revision Total Hip Replacement
The process of revision total hip replacement is much more complex and time-consuming than primary hip replacement surgery. The general flow of revision total hip replacement is:
Pre-operative workup: in this part of the surgery, the assessment of medical history, tests and screening will be done to evaluate the damage of the bone and to the previously implanted prosthesis. This will help the surgeon develop a specific surgical plan.
Anesthesia: the surgeon will make the incision only under the effect of anesthesia to alleviate pain and irritation. The incision can be made on a previous hip replacement incision or it can be a new incision altogether. This typically depends on the extent of the procedure.
Dislocating the previous implant: The surgeon will carefully dislocate the previous hip implant and remove the components from the hip joint. This could involve cutting and removing bone or cement that perhaps was used to hold the implant in the place from the primary surgery.
Removing the Old Components: The surgeon will remove the old components of your joint replacement, including the cup (socket) as well as the femoral stem (the part that is connected to the thigh bone). Your surgeon will use specific instruments and techniques to remove any cement or damaged portion of a bone.
Preparing the Bone: After the old implant is removed, the surgeon will prepare the remaining bone surfaces to receive the new components. This may include removal of any existing cement, cleaning of the bone, and shaping the bone to accept the new implant.
Inserting the New Components: The surgeon will insert the new cup and fix it into the new socket either using screws or a press fit. A new femoral stem will be inserted into the femur and fixed either with a bone cement, or depending on the quality of the bone, will be fixed with available press fit techniques.
Closure: At the end of the procedure the surgeon will close the incision with sutures. A sterile dressing will be placed over the wound. After closing the incision, medications to prevent thrombosis (blood clot formation) and infection are necessary to not lead to further complications.
Post-operative care: the medications to prevent thrombosis and infections are necessary to avoid complications. Physical therapy is also necessary to restore full range of motion, good joint and muscle function, and to regain muscle strength.
Best Doctors in India
Cost of Revision Total Hip Replacement Surgery in India
In India, an average revision (second) hip replacement surgery typically costs between 4500 USD and 8000 USD. Prices will vary according to several factors, including the hospital, the skill level of the surgeon, and the individual patient. Moreover, the price will vary based on the particular city where the surgery will take place.
|
Cost of Treatment Cities in India |
Min (USD) |
Max (USD) |
|
Bangalore |
4500 |
6500 |
|
Delhi |
6000 |
8000 |
|
Mumbai |
6500 |
8000 |
|
Gurgaon |
6000 |
8000 |
|
Chennai |
3500 |
6300 |
|
Hyderabad |
4500 |
7000 |
|
Pune |
6300 |
7500 |
|
Kolkata |
5000 |
6000 |
|
Kochi |
3700 |
5500 |
Top Hospitals in India
Indications of Revision Total Hip Replacement Surgery:
There are specific situations where revision total hip replacement surgery is indicated. Some of the indications are as follows:
- Failed prior hip replacement surgery
- Fracture surrounding the hip replacement components
- Instability of the implant
- Wear of the component
- Metal allergy
- Complications of osteoporosis
- Aseptic loosening
- Infection
- Dislocation
- Bone loss
- Malposition of the component
- Reaction to metallic debris.
Risk Factors:
The revision total hip replacement is a very complex procedure and there are many risk factors. Some of these risk factors are listed below:
Loosening of an Implant
In certain individuals, too much physical activity and obesity can lead to loosening of the implants causing discomfort, a diminished range of motion, and diminished stability for daily activities.
Infection
Infections can occur right after surgery, but sometimes infections seem to occur late. In the case of delayed onset, infection-causing agents, primarily bacteria, enter the blood and migrate to the hip joint complicating the healing process.
Fractures
Fractures in hip surgery can occur from poor technique and equipment used in total hip revisions. This is serious because fractures can injure bones and tissues and produce failures in revision surgery.
The presence of other diseases
Diseases such as diabetes, obesity, heart disease, and some autoimmune diseases can slow healing, make complications worse, and to cause dislocation of the hip joint for which further surgery is required.
Surgical complications
The surgical procedures can also cause a great deal of complications. Some of these complications are surgical errors, improper positioning of the implant, inadequate soft tissue repair, neurological and vascular damage, and delayed wound healing.