| Approximately, 500,000 Americans undergo
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| | presents another problem since the
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| either total hip or total knee
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| | orthopedist must find a correct-sized
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| replacement surgery annually. The
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| | mate for the remaining implant section.
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| underlying reason is usually end-stage
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| | This can be a complicated process since
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| arthritis- when the cartilage which
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| | the part may need to be sculpted to fit
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| cushions the joint has worn away.
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| | just right.
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| Technology has improved to such a point
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| | Surgery can take anywhere from an hour
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| that these replacements which consist of
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| | for a partial replacement to five or six
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| metal, plastic or ceramic materials and
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| | hours for a completely new hip or knee
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| mimic the function of a normal joint, are
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| | joint.
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| usually very effective.
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| | Age does not appear to be a limiting
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| Most patients can return to activities
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| | factor and people of any age are eligible
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| they enjoyed before their joint became
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| | for revision surgery. The primary factor
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| diseased. But after 10 to 20 years these
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| | that determines whether a patient will be
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| replacement joints may also wear out,
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| | suitable is their overall health. If they
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| requiring a second or even third
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| | are in good health, then revision is a
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| replacement surgery. This procedure is
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| | good option.
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| called a revision joint replacement. As
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| | Another factor is quality of life. If a
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| one might imagine, these subsequent
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| | patient cannot function without a
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| replacements can be much more complicated
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| | revision, then surgery is probably
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| than the earlier surgery.
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| | indicated.
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| There can be several reasons why a
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| | The rehabilitation following revision
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| revision could be required. Sometimes the
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| | surgery is much harder and takes much
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| hip begins to dislocate. This can happen
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| | longer than a first time replacement.
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| either many years later from overuse of
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| | While patients can bear weight almost
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| the joint, or shortly after the first
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| | immediately after a first joint
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| surgery if there were technical problems
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| | replacement, revision patients must wait
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| or errors in getting the prosthetic joint
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| | six weeks or longer. The rehabilitation
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| in place.
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| | also is much more gradual than for first
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| Patients don't always heed instructions
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| | timers. So how can a person prevent the
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| so that they may exert too much stress on
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| | need for having a revision?
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| a fresh prosthesis before they should.
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| | Joint replacements nowadays generally
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| This can cause the replacement to fail.
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| | last 20 years compared with 10 to 15
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| A dreaded complication of joint
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| | years for older models. There are things
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| replacement is infection occurring
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| | people who have undergone revision can do
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| shortly after surgery. The appliance
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| | to prolong the lifespan of their replaced
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| needs to be removed and the patient will
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| | joint and lower the odds of eventually
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| require long term intravenous
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| | needing a revision surgery.
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| antibiotics. After the infection is
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| | Patients must realize that though they no
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| totally cleared up, the patient will
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| | longer have pain, this does not mean they
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| require a revision operation.
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| | can return to their previous activity
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| The most common cause for revision
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| | level, particularly if that activity
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| surgery is progressive wear and tear of
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| | level was extreme.
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| the initial prosthesis. Over time, these
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| | While regular exercise and recreational
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| prostheses can loosen or wear away. A
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| | activities are recommended, it's
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| patient can experience symptoms such as
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| | important for a patient to use
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| pain, and reduced range of motion of the
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| | moderation.
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| joint.
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| | Some examples... an elliptical trainer is
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| There are a number of reasons why a
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| | better than a treadmill. Cycling is more
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| revision surgery is so difficult.
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| | advisable than running. If a patient is a
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| Firstly, the original implant has to be
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| | tennis player, they should play on soft
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| taken out. Over the years, soft tissue
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| | courts rather than hard. And so on...
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| structures around the joint can change.
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| | Maintaining ideal weight is critical.
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| There is the development of scar tissue,
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| | Regular visits to the joint replacement
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| alteration of bone structure, loosening
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| | surgeon are advisable since they can
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| of ligaments and so on. These changes
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| | sometimes spot problems before they
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| make a revision surgery very different
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| | occur.
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| and much more difficult from a first
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| | It's also important to remember that
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| surgery where the anatomy is not
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| | patient should go to a hospital that
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| distorted.
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| | specializes in joint replacements,
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| Prior to surgery, different imaging
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| | especially revision replacements, if they
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| procedures such as x-rays with multiple
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| | need a revision.
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| views, CAT scanning and MRI are required
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| | These operations require extensive
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| to give the surgeons a road map.
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| | training and a well-coordinated team of
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| Sometimes, the bone around the joint has
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| | experts to get the best results. Surgical
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| eroded and grafting of new bone is
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| | errors by inexperienced doctors can lead
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| required.
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| | to complications and the need for
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| While most patients require total implant
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| | additional operations.
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| replacement, sometimes only a portion of
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| | The best place to go is an orthopedic
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| the prosthesis needs to be replaced,
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| | specialty hospital or a teaching
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| rather than the whole thing. This
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| | hospital.
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