Revision Joint Replacement Surgery - Trading Parts?

In my last blog entry, I mentioned that joint replacements don't always last a lifetime. This is especially true of (and predicted for) the rising number of younger patients (i.e. under 50) who are opting for a joint replacement surgery at younger and younger ages.

Many have the mindset of "give me a new, pain free joint, let me get active, beat it up, get good use out of it, and when it wears out or loosens, remove it and pop in another - hopefully a newer, cooler model." This line of thought may sound reasonable, but I assure you it is not.

Revision joint replacement surgery is becoming more and more prevalent. Joint replacements are predictably wearing out (although some can last a lifetime - if you take care of it, and are a little lucky), and the numbers of revisions are on the rise.

It is not a simple process like getting new brakes or tires for your car. Revision surgery is much more complex a surgical procedure then the primary joint replacement. It is a longer, more complicated, technically demanding surgery, where optimal positioning and fixation of the prosthesis is a real challenge.

With revision joint replacement surgery, the recovery is also longer, with more of a toll on the patient, and even a higher complication rate. They probably won't last as long, as well.

The good news is that I believe that revision total joint surgery will evolve. The higher demand will create better procedures, better techniques and better prostheses (i.e. replacement parts).

Unfortunately, at present, there are not enough orthopedic residents in training, especially in the area of complex joint replacement and revision surgery, to handle this increased demand. Hopefully that will change, but that's another story.

So my best advice is to delay your primary joint replacement as long as you can (comfortably/functionally) and exhaust other methods of preserving your failing joint. When you finally need to take the plunge, find a top-notch surgeon and, most importantly, take good care of your new joint so that hopefully at last as long as you do.