Loosening of the hip prosthesis

Not least because of the high life expectancy, a change of hip prosthesis is now quite common. Therefore, it is not uncommon to have a replacement operation after the prosthesis has been loosened, although it is always a complex and technically very difficult procedure.Unlike the initial operation, the loosened prosthesis must first be removed. This means that a stage must be created that allows a new prosthesis to be anchored back into the bone at all.

Depending on the individual circumstances, this may result in larger bone defects, which are then filled with the patient’s own bone from other parts of the body, with replacement bone from the bone bank or with cement. Which method is used in each individual case depends on the individual circumstances and is not least the decision of the doctor performing the replacement operation. However, the decision depends to a large extent on the age of the patient, his mobility and the quality of the bone.

In the case of very thin bone or bone weakened by an advanced stage of osteoporosis, the surgeon can additionally reinforce the shaft of the thigh with a plate (stainless steel or titanium). This measure increases the resistance and load capacity enormously. As already described in the context of hip joint endoprosthetics, a replacement operation also carries the risk of high blood loss.

Since this is a planned procedure, it is possible to donate your own blood some time before the planned operation. This has the advantage that foreign blood does not have to be used. So-called retransfusion systems are also being used more and more frequently, which process the blood from the wound directly and can be returned as an autologous blood sample.

The question of how often one can perform a retransfusion operation cannot be answered here in a generalized manner. The given, individual factors must always be taken into account. However, one should always be aware of one thing: With each replacement operation it becomes more difficult to anchor the prosthesis firmly in the bone.

At this point, special prostheses should be mentioned, which the operating physician may consider if a firm anchorage in the bone is hardly possible. In very difficult cases of a loosened prosthesis, it is also possible that the loosened prosthesis is removed completely and not replaced at first. This is called the creation of a so-called Girdlestone situation. It depends on the individual case whether another hip joint will be installed in the future or whether the above mentioned Girdlestone situation will be maintained.