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HIP SURGERY
 
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Trevor Larence Hip & Knee surgeon - revision hip surgery

REVISION SURGERY 


The purpose of Repeat surgeryalso known as Revision surgery, is to replace or compensate for a failed hip or knee replacement implant. Data collected since 2004 by National Joint Registry confirms Mr Lawrence's success record is appreciably beating the UK average.

Following a hip replacement, major complications are rare. But should a problem arise, given the complexity of such operations, an experienced surgeon is essential. Since the beginning of his career as an orthopaedic surgeon, Mr Lawrence has undertaken well over 600 revision hip replacements and is best placed to find the most effective solution for the patient.

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PAIN

Hip replacements are generally pain-free. However, in the unlikely event of developing groin pain, or thigh or buttock discomfort associated with the physical activity, the hip replacement should be checked out by a specialist as soon as possible. Pain in the upper thigh may be the earliest sign that the hip implants may have become loose, or the joint has become infected.

If you have a resurfacing hip replacement, pain may be related to an allergic reaction to the metal debris. In addition, the ball of the hip joint may have died, minor fractures may develop around the hip surfacing, or the joint may be infected. Urgent assessment is advised.

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INFECTION

Features of infection include:

  1. Heat, redness or swelling of the wound.

  2. Continuous fluid  ooze through the skin,

  3. Severe pain in the hip  and

  4. Unexplained temperatures.


Please get yourself checked out urgently if you develop any of the above.

 

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DISLOCATION

If the hip joint feels unstable or has popped out of its socket on several occasions, further surgery may be required. The hip may start dislocating because the implants have become loose or have worn out. Alternatively, the alignment and positioning of the hip replacement may be poor, and repositioning may be indicated.

 

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IMPLANT LOOSENING

The most typical reason for a hip replacement becoming painful is that the implants have loosened from the bone. The continuous jolting of the loose implant results in erosion of the bone, which in turn becomes weakened. It is, therefore, best to address the loose implants early.

Once the implants have been removed, the degree of damage to the surrounding bone is determined. If there is minimal damage, excellent results can be obtained by re-cementing new implants. When there is extensive damage to the bone, grafts will be necessary to build up the deficiency. Recovery will then be slower.

The bone graft is usually obtained from the hip joint ball donated by patients previously undergoing a hip replacement. The hip joint ball is removed at the time of surgery, irradiated to remove contaminants, and then frozen. Patients donating bone are tested to ensure that they are free from any diseases that could be transmitted through the donated bone.

The ball of the donated hip joint is broken up into small fragments and impacted at the site of bone loss. New implants are then cemented into place. It takes months to years for the grafted bone to become part of the skeleton. As a result, depending on the amount of graft used, patients may experience partial weight-bearing for six weeks. The significant advantage of using a bone graft, especially in young patients, is that the bone stock is eventually restored. As a result, if any future operations are required, they will be very much easier to do. On occasion, the bone loss may be so significant that the whole of the thigh-bone needs to be replaced by a metal implant together with grafting of the pelvis. 


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