After completing his Australian orthopaedic training, Dr Tsung spent 12 months working at the prestigious Princess Elizabeth Orthopaedic Centre in Exeter, United Kingdom gaining unique experience in the treatment of failed joint replacements, including restoration of bone stock with impaction grafting techniques and contemporary reconstruction techniques for dislocation, loosening and fracture.
When Do I Need Surgery?
Joint replacement surgery is undoubtedly one of the greatest medical advances of our time improving quality of life by easing pain, improving range of motion, and increasing activity levels.
Despite this fantastic success rate, just under ten percent of implants will fail and require a second procedure, called revision, to remove the old implants and replace them with new components.
Joint revision surgery is a complex procedure that requires extensive preoperative planning, specialised implants and tools, and mastery of difficult surgical techniques to achieve a good result.
When a joint replacement fails, one or more of the following may occur:
- Joint swelling
- Joint pain
- Limp when walking
- Feeling of giving way
Why Do Joint Replacements Fail?
In general terms, joint replacements may fail for any of the reasons listed below:
Some revisions are necessary because the implants have loosened their grip on the surrounding bone. For a variety of reasons the initial firm fix on bone has loosened off which may lead to a change of position of the implant (‘migration’), weakening of the surrounding bone and ultimately pain.
The large foreign metal and plastic implants can serve as a surface for bacteria to latch onto. In addition, the tissue that has been previously operated on has an altered blood supply, which may not be able to fight infection effectively. Even with a well functioning joint replacement, ongoing infection makes revision necessary.
The risk of infection following a primary (first) joint replacement is estimated at around 0.5%.
Dislocation is a sudden popping out or migration of the implant from its normal position more frequently encountered in hip rather knee replacements. The rate of dislocation after hip replacement is estimated at around 1%. Some of these patients will experience multiple dislocations and require revision surgery. The dislocation may be related to many complex factors such as loosening, poor muscle strength or tone, bony or scar tissue impingement, incompatible component position, chronic nerve problems (e.g. as neuropathy or Parkinsons Disease), or patient noncompliance.
Younger and more active patients have a higher rate of revision. Obese patients have a higher incidence of wear and loosening. Patients whose primary surgery was performed for inflammatory arthritis, patients with avascular necrosis, and patients with a previous hip fracture are at higher risk for loosening.
Contact Dr J Tsung
|1300 399 223|
|(07) 3041 5087|
Suite 6C Fred McKay House
42 Inland Dr, Tugun Qld 4224