How safe are metal-on-metal hip implants? | The BMJ
Each of these symptoms should be evaluated by the surgeon to help determine if the hip replacement has something wrong with it or if it is functioning as expected. A variety of tests are available to the surgeon and often many of them are necessary to sort out the issues that have left the primary hip replacement dysfunctional. Many of the common causes for failed total hip which would lead to the need for a revision of part or all of the prosthetic implant are discussed below.
Symptoms of Hip Implant Failures
The major causes of failure in hip replacement are: dislocation of the joint, loosening of the stem and cup, and failure of the stem. Dislocation of the prosthesis can occur immediately after surgery if you move your leg into a prohibited position. It is therefore necessary to avoid extremes of , , and for about 12 weeks until a thick capsule forms around the artificial joint. If you dislocate, you will need to be put under deep anaesthesia so your hip muscles can relax sufficiently to allow the artificial hip joint to be reduced. Care should be taken to avoid dislocation as the sciatic nerve, which supplies large leg muscles, is in danger of damage when your hip dislocates.
In almost all cases, the presenting symptom of a failed hip implant is PAIN! This is especially true if the implant is coming loose from the bone or there is an infection around the implant. Associated symptoms include stiffness of the joint or a persistent limp. In the case of instability or frank dislocation, the hip may feel just fine until which point, with even a slight twist, it disengages from the socket and pops out, leading to sudden pain and an inability to bear weight on the involved leg.
When hip and knee replacements fail, ..
Nevertheless, as a cause leading to revision hip replacement, infection is the third most common. In several studies which assess the causes of primary hip replacement failure, infection of the joint is the most challenging and potentially devastating cause with 15% of all revision hip replacement procedures being done for this reason . If an artificial joint becomes infected, the pain is typically more constant than with a loose, but non-infected joint, but symptoms greatly vary with the type of infecting organism. Along with pain, symptoms include a stiffening of the joint, making movement quite difficult. On rare occasion, a prosthetic joint infection can make the patient systemically ill with fever, chills, weight loss, and lethargy.
Hip Replacement Dislocation: Symptoms and Treatment
Despite constant improvement in the articulation of hip replacements, a certain amount of wearing is going on over time due to friction between the ball bearing and the socket surfaces. This mechanical wearing generates very small particles of metal, ceramic, cement or plastic which in turn collect in the tissues about the hip joint. The patient’s immune system has cells which clean up these foreign particles and dispose of them. Interestingly, this normal protection response can lead to the resorption and destruction of the bone that supports the socket and the stem through a process known as “osteolysis.”
Total Hip Arthroplasty 27130 M16.10 | eORIF
radiolucency).This did not necessarily mean an implant failure was inevitable, but it was something that needed to be watched.I had had perfect function of the hip and no pain except for a little soreness when I had been on my feet all day.I had already been diagnosed as having a soft bone condition at the time of surgery with small sponge-like crevices on the top of the femur.
Revision Hip Replacement - Zehr Center Orthopaedics
The main long-term threat to hip replacements appears to be polyethylene and metallic wear debris from the interacting surfaces of the components. This debris can cause inflammation in adjacent tissues that results in bone loss which, in turn, leads to prosthesis loosening. Up to 35% of retrieved modular prostheses exhibit corrosion or other evidence of damage. Fracture, dislocation, malpositioning of components, infection around the implant, poor cementing technique, and certain stem designs can also contribute to loosening of the stem component.