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Orthopedic Surgeons Take on Their Greatest Challenge of the Decade: Hip and Knee Revision Surgery

Jun 21, 2011

CHICAGO (June 21, 2011)—As people live longer and they get total joint replacements at a younger age, orthopedic surgeons face their greatest challenge over the next decade: a rapid increase in the number of revision surgeries, when old implants are removed and replaced with new components. The procedure brings with it an increased risk of complications; still more than 90 percent of patients who undergo revision procedures are expected to have good to excellent results.

“With more people beginning to hit the age when they need their implants replaced, better implants and improved techniques will be needed,” said Henry Finn, M.D., medical director of the Chicago Center for Orthopedics at Weiss Memorial Hospital and professor of surgery at the University of Chicago. As a leading revision surgeon, Dr. Finn has engineered a number of implants, including the Finn Knee System, a limb salvage prosthesis that was noted as a significant advancement in orthopedics in the last century by the American Academy of Orthopedics (AAOS). He also pioneered various techniques to help these patients faced with revisions.

More than one million total joint replacement surgeries were performed in the United States in 2009; 10 percent of them were revisions. There were 60,245 knee revisions and 41,225 hip revisions.

“More and more, we’re seeing patients from 20 and 30 years ago who had their first joint replacement and now they’re dealing with pain again due to wear of the implant bearing, loss of bone or infection,” Dr. Finn said. “They’re outliving their implants and need revisions."

By 2030, the AAOS predicts 3.4 million Americans will need knee replacements and the number of patients getting hips replaced will grow to 572,000.  In recent years, hip and knee replacements have proven to last 10 to 20 years in 90 percent of patients due to innovations in implant technology and improved surgical techniques.  With more total joint replacement patients now faced with revision surgery, they may be relieved to hear a carefully planned and executed surgery may equal the results of a primary procedure.

“We try to preserve what we can, but old parts may be obsolete, so many times we combine old parts with new implants,” Dr. Finn said. Depending on the age and condition of the patient, orthopedic surgeons will select the best implants to use—usually a combination of metal, ceramic and plastic parts—and secure them with biological or cement fixation and bone grafting.

“The goal is always to do what’s best for the patient in relieving pain, restoring mobility and quality of life.”

Louis Olguin, 58, of suburban Chicago suffered for years following a knee injury while serving in the U.S. Marine Corps in the 1970s. He underwent 15 surgeries before receiving the Finn Knee System in 1990. The surgery helped him to reclaim his life.

“He saved my life,” Olguin said of Dr. Finn. “He’s my guardian angel.” In 2010, Dr. Finn implanted some new parts in his left knee, which are expected to last 20 years.

Marcia Ybarra, 56, of North Central Illinois had been in pain the better part of 26 years following a staph infection, which ate away at her hip cartilage and part of her pelvic bone. She underwent a dozen hip surgeries before seeing Dr. Finn.  Using a special technique with pins and cement, Dr. Finn reconstructed her pelvis and Ybarra has since pushed her wheelchair aside.

“I was a bodily mess,” Ybarra said. “Dr. Finn is my hero.”

Many more advancements have been made in recent decades, but surgeons are continuing to refine implants and techniques as they prepare to face a more complicated patient—due to a growing aging and obese population—in need of revision surgery.

For more information on joint revision surgery, visit the Chicago Center for Orthopedics at Weiss at ChicagoOrtho.com or call 888-503-ORTHO (6784) to get connected with a physician for consultation.