治疗髋关节症状 & 膝关节置换术失败
大发娱乐犹他大学的骨科医生为髋关节置换术和膝关节置换术的翻修大发娱乐提供卓越的护理. We see patients from all over the Mountain West region who underwent a 臀部 or 膝关节置换 和 need to have another procedure to correct a problem, reduce instability, or treat infection.
We perform revision surgery on anyone who needs our help. 无论你的髋关节或膝关节置换手术是在U的U健康或其他机构进行的.
Our team-based approach to 臀部 和 knee revision surgery incorporates the expertise of:
- 整形外科医生,
- 医生,
- 医师助理
- 住院医生和其他外科医生
- 传染病医生，
- 物理治疗师,
- 职业治疗师,
- 护士,
- 营养师,
- 其他非临床专业人员.
臀部 & 膝关节翻修标准
A 全髋 or 膝关节置换 does not replace your original joint perfectly. 一些患者即使在关节置换术后仍然会感到轻微的疼痛或不适或行动困难. 然而, 并不是每个出现症状或问题的人都适合做髋关节或膝关节置换术.
为了确定你是否适合做整形手术，你的骨科医生会：
- schedule an appointment for a physical exam;
- order imaging tests, such as an X-ray or CT scan to further evaluate the joint; 和
- diagnose the cause of your joint instability, pain, or dysfunction.
Due to the complexities of revision surgery, 大发娱乐的整形外科医生不会进行这些手术，除非他们能清楚地识别出可以通过手术解决的机械或结构问题. The first step is to schedule an appointment with an orthopedic surgeon to discuss your 症状 和关切.
髋关节的好处 & 膝关节翻修手术
如果你经历过 complications after a joint replacement surgery (immediately or several months or years later), a 臀部 or knee revision procedure will:
- 缓解疼痛,
- 增加流动性,
- 提高力量和协调性；
- reduce the frequency of 臀部 or knee dislocations,
- 治疗感染，以及
- 提高关节的稳定性.
Find a Joint Replacement Specialist
髋关节准备 & 膝关节翻修手术
以下是一些重要的事情，你可以做准备的髋关节或膝关节翻修手术，将减少 并发症风险 并大发娱乐提高你的 恢复过程.
- Lose weight or maintain a healthy body weight. Most surgeons will require you to have a BMI below 40, but a BMI below 35 can further reduce your 并发症风险. Being underweight is also a potential risk, especially if you are malnourished. If you need help with nutrition or weight loss before surgery, talk to your orthopedic surgeon about resources available through U of U Health.
- Work with your primary care provider or specialist to get other health conditions under control, such as diabetes or high blood pressure.
- 停止使用尼古丁 at least four to six weeks before surgery.
- Decrease your alcohol intake or stop drinking alcohol at least one to two weeks before your procedure.
- Reduce your narcotic use prior to surgery. This will give you the best chance of controlling your pain after revision surgery.
为照顾者做计划
You will need to have a family member, 朋友, or caregiver take you home when you are discharged 和 provide assistance at home. 在接下来的几个星期里，你需要别人帮你处理日常事务，比如购物、洗澡、洗衣服和做饭. 你将不能开车，需要搭车去看医生或其他必要的旅行. 如果你在手术后没有人可以大发娱乐你，大发娱乐的社会工作者将为你大发娱乐提供资源和推荐.
回家准备
You will need to prepare your home so you can get around with a walker, 拐杖, or other assistive devices while you are recovering. If your home is not suitable for recovery 和 you cannot make modifications, 在髋关节翻修或膝关节翻修置换手术后，您可能需要留在康复中心或专业护理机构.
How Long Does 臀部 Or 膝关节翻修手术 Take?
Revision surgeries usually take between three 和 five hours, 但有些可能需要更长的时间, depending on the type of 臀部 or knee revision surgery. 你的外科医生会有多种潜在的手术计划和突发事件，这样他或她就可以根据他们在手术中发现的情况来修改和适应. 大发娱乐的整形外科医生有经验和资源来适应这些手术中可能发生的变化和或不可预测的事件.
手术过程中会发生什么
You will be placed under anesthesia (put to sleep) for the duration of the surgery. 在某些情况下, your surgeon may recommend a spinal epidural where you are awake, but your body is numb from the waist down. 你的麻醉师会在手术前和你讨论任何额外的疼痛控制方法.
Once the 臀部 replacement or 膝关节置换 revision surgery begins, your surgeon will:
- Make an incision (cut) in the area of your joint. This typically follows the same incision line from your initial replacement surgery. 然而, 它可能需要比原来的切口更长，以允许你的外科医生移除关节部件.
- 一旦关节暴露，检查软组织和关节是否有松动和不稳定的迹象.
- 检查您的髋关节置换或膝关节置换假体（人工身体部分）的所有部件，找出哪些部件不合适, 宽松的, 或损坏.
- 小心地取出原种植体（或部分种植体），以避免损坏现有的骨. If cement was used during your original 臀部 or 膝关节置换 surgery, 你的修复过程可能需要更长的时间，因为你的外科医生可能会在试图避免不必要的骨质流失的同时移除骨水泥.
- 有时需要进行有控制的骨折，以移除诸如股骨干（从髋关节延伸到大腿骨的髋关节置换关节的一长段）之类的部件。. Your bone will then be reattached to heal.
- Perform revision bone cuts to get the bone surfaces ready for new implants, once your surgeon removes the original parts from your 臀部 or 膝关节置换. 如果有明显的骨质流失，你的外科医生可能会增加骨移植物或用金属增加一些区域.
- Place the revision implant parts in your 臀部 or knee, 以及任何必要的骨水泥, 螺丝, or other devices to hold them in place while it heals.
- 对手术前或手术中受损的周围组织进行其他必要的修复, 然后闭合切口（切口）.
- 你的外科医生可能会插入引流管或切口真空敷料，以防止液体或血液在你的皮肤下或皮肤上积聚. You may need this for several days to several weeks following surgery.
手术后
When your surgical procedure is complete, you will be taken to a recovery room until you wake up from your anesthesia. We will transfer you to a hospital inpatient room. 大多数患者在出院回家或到专业护理机构之前会在医院住一到两个晚上.
如果你有感染，需要静脉注射抗生素或外周插入中心导管（PICC），你的医生可能会让你在医院呆更长时间. 人保险是一条细线, 软管插入静脉，将保持连接你的静脉更长的一段时间. 医生可能会建议使用PICC线，而不是频繁地使用静脉注射抗生素.
清创手术
If your 臀部 or knee revision is the result of an acute (recent) infection, your doctor may recommend a surgical procedure called an incision 和 debridement. During this procedure, the surgeon will:
- 打开髋关节或膝关节，
- 洗掉细菌，
- 换掉关节内的衬垫和球（用于髋关节修复）或塑料垫片（用于膝关节修复），同时保留金属植入部件附着在你的骨头上, 和
- 闭合切口（切口）.
手术后4到6周，你需要静脉注射抗生素来治疗感染.
了手术
Severe or chronic infections may require the removal of your whole 臀部 or knee joint. When this happens your surgeon will usually perform the procedure in stages.
- 阶段1: 取出植入物，放入一个临时装置，里面装满了抗生素，可以抵抗关节部位的感染. 在你接受静脉注射抗生素期间，这个临时的垫片可能需要在你的臀部或膝盖上放置几个月.
- 阶段2: Once your surgeon is satisfied that the infection is gone, 他或她将进行第二次手术，取出垫片，放入新的永久性髋关节或膝关节假体（人造身体部分）。.
How to Make An Appointment with Our Joint Replacement Specialists
如果你经历过 症状 of a 臀部 replacement failure or 膝关节置换 failure预约大发娱乐的整形外科医生，他擅长关节置换手术. You can get a referral from your primary care provider or another provider, or you can contact us directly by calling 801-587-7109 预约会诊.
一些保险计划要求你从你的初级保健大发娱乐提供者那里得到推荐去看专家. 在你预约之前，先和你的保险公司确认一下你是否需要转诊. 您的保险公司将大发娱乐您回答有关您的保险范围和费用的髋关节或膝关节翻修手术的任何问题.
