When to change a prosthesis?

When to change a prosthesis?

Written by: Dr. Francesc Anglés Crespo
Published: | Updated: 21/08/2018
Edited by: Top Doctors®

The main reason for a prosthetic replacement surgery is performed is pain. Pain indicates that the prosthesis does not work properly. The most common cause of prosthetic replacement is aseptic loosening.

hip The duration of a prosthesis depends on many factors, not only it depends on the type of implant, but has much influence the position of the components and the surgical technique.

Almost always the pain is the symptom that justifies replacement. The only exception, cases of patients without symptoms in which wear in the prosthesis is detected during radiographic controls.

This situation must be evaluated symptoms, however slight, repeat the controls and discuss the risks and benefits of a review theoretically simple but not without complications.

Generally, before a painful prosthesis it should rule out an infection that sometimes can not give the typical symptoms. For this, the patient history is fundamental.

 

Causes replacement prosthesis

It is very important to know what causes it raises make a prosthesis replacement surgery; as, for example, in the case of hip replacement increases the risk of dislocation.

The most common cause of prosthetic replacement is aseptic loosening. The wear of the components of the prosthesis generates particles and an inflammatory reaction of our body against these particles does not distinguish our own bone affecting him and causing loosening and bone loss. In this situation, the replacement prosthesis is made in a single surgery. Generally it requires more complex implant.

The wear of the prosthesis depends on the quality of the friction surfaces and the friction torque, the orientation or position of the components in the first surgery; but there is individual variation in the body's reaction to wear.

The pairs of friction with reduced wear are hard pairs: the ceramic / ceramic and metal / metal (the latter pair is not used for other problems) rather hard pairs, which are more common, the ceramic / polyethylene and metal / polyethylene. Now, with the latest generation polyethylene wear it is expected to be lower.

On the other hand, if the cause of replacement prosthesis is an infection, most often perform this surgery in two surgeries parts. Surgery to remove the implants, after which it must do a course of antibiotics. Subsequently, the second operation in which a new prosthesis is implanted is performed. Currently, in certain situations you can make the parts in surgery though not as usual.

*Translated with Google translator. We apologize for any imperfection

By Dr. Francesc Anglés Crespo
Orthopaedic Surgery

Chief of Orthopaedic Surgery University Hospital Mutua Terrassa, Dr. Anglés Crespo is a renowned expert in orthopedic osteoarthritis in different joints. He is Chief of Orthopedic Surgery and Traumatology University Hospital Mutua Terrassa. In addition, he is member of several companies, including the Catalan Society of Orthopaedic Surgery, the Spanish Society of Orthopaedic Surgery, the International Hip Society and the American Academy Orthopedic Surgeons.

*Translated with Google translator. We apologize for any imperfection

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