Too often, Andrew J. Wassef, MD, sees patients who have been living with pain for years after a hip or knee replacement. While occasional soreness may be normal, pain on a daily basis is not, he says. Here, Dr. Wassef, an orthopedic surgeon who specializes in robotic-assisted joint replacements and revisions at Providence Little Company of Mary Medical Center Torrance, discusses how joint revision surgery can help patients relieve pain and take back their lives.
Who should consider joint revision surgery?
The majority of total [hip and knee] joint replacements are very successful. There is a small minority, however—with total knee replacements, traditionally about 10% to 12% of patients—who have problems. Then there’s a smaller subset of patients with problems that drastically affect their normal activities of daily living. People who have had infected total joints are almost always candidates for revision surgery. If we determine that revision surgery is going to offer a substantial benefit in terms of your pain, activity and function, then you’re a good candidate.
Why do some initial joint replacements not work out well?
They’re each quite unique. Many times, it’s a mechanical issue that can be fixed with revision surgery. When instability is the problem, it’s usually because the ligaments have somewhat stretched out or the original replacement just wasn’t optimal for that patient’s anatomy. In some cases, patients had a total hip or knee replacement 20 to 25 years ago and the parts are worn out and they need to have revision surgery to get new parts.
What are the options for revision surgery?
We always start with conservative management for the majority of problematic total joint replacements and do our best to avoid surgery. However, if we feel surgery is necessary, sometimes we revise a small portion of the replacement. Sometimes we’ll take out all the components and start over from scratch and rebuild it. We use the most cutting- edge technologies, such as CT scans for imaging and robotic-assisted surgery, to plan for the revision. At Providence Little Company of Mary, we are invested in making sure that we have everything we need, including custom tools, to help us remove implants and put new ones in safely.
What should you expect after revision surgery?
Having a successful revision experience often leaves patients more mobile sooner after their revision surgery than they were after their initial surgery. We see a lot of patients who are in the hospital for only one or two nights and are able to go home feeling great. The most gratifying part of doing revision surgery is seeing a patient who was in a severe amount of pain enjoy their lives again. The hospital has done a great job in building a joint replacement and revision program to make sure that patients have a place they can come when they have these difficult problems.
For more information on joint revision surgery, call 844-925-0942.
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