Two-Stage Joint Revision: What Patients Should Know
Posted on: 29 December 2020
Finding out that your hip prosthesis is infected is bad, but you might also need to have not one but two major surgeries as a result. Two-stage revisions for infected hips have become increasingly standard when the prosthetic hip has become useless due to bio-film. Read on for a step by step guide on what to expect with your revision process.
1. Your joint infection is evaluated
You will likely know you have a joint infection by the usual signs of pain, swelling, fever, and maybe even leakage from the incision site. Your orthopedist might withdraw some of the fluid and check it for common bacterial strains like Methicillin-Resistant Staphylococcus Aureus (MRSA). Unfortunately, if bacteria is present, it also means your prosthetic hip is negatively affected. Infections like MRSA tend to gravitate toward implanted devices and coat the device in bio-film. That breaks down the structural integrity of the device, making it useless.
2. Stage-one surgery
The old infected device is removed and replaced with a temporary device (called a spacer) that is constructed to fight infections. The device itself is made of antibiotic-laced materials. In addition, during surgery, the area is carefully washed to remove bacteria and filled with antibiotic time-release pellets meant to fight off any further infection.
3. The waiting period between surgeries
This time is spent doing more warfare against the infection. For about six weeks, intravenous (IV) antibiotics are pumped into your body once a day for about an hour. You may need to go to a medical facility but it can also be done at home with the help of a home health nurse. To protect your kidneys from being negatively affected by the very strong antibiotics, you will need constant blood monitoring and additional fluids by IV in some cases.
4. Getting around
You may be able to get around if you can avoid putting weight on the affected hip. The spacer is not meant to take your full body weight so you must use a walker and/or a wheelchair when you walk.
5. Stage-two surgery
You may be asked to submit blood for a test of certain markers to determine how effective the antibiotic therapy has been. If given the go-ahead, you will be scheduled for the second and final surgery. The temporary spacer is removed and the area is tested for infection and cleansed before the new, permanent device is implanted. After this final surgery, most people are able to walk putting full body weight on the implanted hip.
This is a complex surgery but the chances of success are great. Talk to a joint replacement surgery service to find out more.
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