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Stay pain-free and mobile
 - With your new revision joint replacement

HeaderImage

Dear Patient,

Prosthetic joints and revision prostheses enable people to enjoy life with pain-free mobility into old age. They are among the best researched of all medical devices. Design, materials and manufacturing methods are continuously optimized, and the surgical techniques are becoming increasingly atraumatic.

The design and proven materials used for modern prosthetic joints mean that they can last a lifetime. However, the bone in which the joint is anchored changes over the years.

The main causes of loosening are age-related bone loss and excessive physical loads on the joint. If a patient is overweight, this too may shorten the life of the joint. 

LINK has been developing high-quality joint prostheses and revision prostheses, made in Germany, for decades.

Loosening is the main reason why it becomes necessary to replace a knee implant, or part of it. Only in rare cases does a serious bacterial infection of the tissue around the implant make a new joint necessary.

Wear and tear can result in a prosthetic knee joint, or part of it, having to be replaced. But with a high-quality implant, this usually only occurs after several decades, if at all. Some patients have the same artificial joint for 30 years without any problems at all.

Pain in the thigh, groin or buttocks may be an indication that your hip replacement has worked loose. You may also experience a feeling of insecurity or unsteadiness when walking and standing. If one leg is suddenly “shorter” than the other, this too may mean that your hip joint is loose. 

A loose knee replacement often becomes apparent due to pain and unsteadiness when walking and standing. Bow-leggedness or knock knees can also be a sign that your knee joint has become loose.

Trust your physician. He knows when your artificial joint needs replacing.
If your existing implant has become loose but there is no infection, then there may be no urgency. But if the tissue around your artificial joint is inflamed, your physician will press for revision surgery at an early date so as to avoid any further complications developing.

The purpose of a revision surgery is essentially the same as when your first artificial joint was implanted. The aim is for the patient to relieved of pain in his/her hip or knee joint, and to remain mobile and enjoy a good quality of life for many more years.

After your revision surgery, you will feel better than before the operation. Ideally you will be able to walk and move without any discomfort at all. This still applies if you are over 70 or 80 years old, and likewise if you have been given your second, third or even fourth joint replacement.

But no artificial joint can be a 100 percent replacement for the original joint. Each time surgery is performed, scar tissue occurs and, at the same time, muscle, bone and tendon substance is lost. For this reason, you may need to use a walking stick or crutch after the operation, and/or you may have to do gait training to improve your walking ability.

Whenever a revision surgery is performed, it can be a challenge for the surgeon to fix the new joint firmly in the bone.
This is because when the old implant is removed, some bone is usually lost and has to be replaced with bone from another part of the patient’s body, or bone graft material from the bone bank, or bone cement.

ersetzt werden. Only then can the new joint be securely and reliably fixed in place.
Even if you are first given an artificial joint early in life, following an accident or illness, you can rest assured that, if necessary, several revision surgeries will still be possible.

The first step in your revision operation is for the surgeon to remove the existing implant, while attempting to conserve as much healthy bone as possible. He then implants the revision prosthesis or components.

If you have a bacterial infection, there are two possible procedures. Either the surgeon implants the revision prosthesis immediately using a bone cement tailored to the spectrum of bacteria present. Physicians refer to this procedure as single-stage revision surgery.

Or the surgeon first replaces the artificial joint with a spacer so that the infection can be treated over a period of time. Later, a second operation is performed in which the surgeon removes the spacer and implants the revision prosthesis. Physicians refer to this procedure as two-stage revision surgery.
The main criterion on which the surgeon decides which procedure to use for your revision surgery is the state of the bone and tissue. The patient’s circumstances and general state of health, and also the type and duration of any infection, also play a part in this decision.

High-grade materials for prosthetic joints

  • Metals such as titanium and cobalt-chromium possess long-term stability, are biocompatible and have a proven track record stretching back decades
  • Special plastics have excellent sliding and friction properties
  • Ceramics are extremely hard-wearing and biocompatible

Check list for your consultation


  •   How are you feeling? Do you feel healthy?
  •   What medication are you taking?
  •   Would you like to donate your own blood for use in the operation?
  •   Would you like to take part in muscle-building and/or gait training?
  •   Do you need to lose weight?

Replacement hips comprise an acetabular cup and a stem, onto which a prosthesis head is attached. The acetabular cup is usually made of a special plastic (polyethylene) or a metal shell with a plastic or ceramic inlay.

All types of prosthesis undergo extensive testing, in which their function, quality, reliability and safety are checked against international industry standards.

Revision prostheses for knee and hip joints can be classified like “normal” joint replacements, e.g., according to

  • The length of the stem of the joint replacement (short or long)
  • The method of implantation (with/without bone cement)
  • The size of the acetabular cup or femoral head


If necessary, revision prostheses can be also be customized to precisely suit the patient’s requirements. For example, for patients who suffer from a metal allergy, the surface of the prosthesis can be coated with a material that prevents migration of allergenic metal ions.

Especially for young patients with biologically vital bone, a short-stem prosthesis is often used for the first replacement. The reason for this is that the surgeon has to remove less healthy bone when a short stem is implanted. A revision prosthesis, on the other hand, usually has a longer stem so that it can be anchored deeply and securely in the thigh bone. The stem must extend deeper into the bone than the “bed” of the first joint replacement.

Just like your first joint replacement, your revision joint should be as perfect a replacement as possible for the natural joint. So it must be located in the bone securely and with millimeter precision. In addition, it has to bear the load of your bodyweight and be able to perform normal everyday movements.

The material of the implant needs to be durable, extremely low-wear, and well tolerated by the body. It should promote bone ongrowth and have anti-bacterial properties to prevent infections. This enables the implant to withstand daily loads over many years. Your physician will discuss with you which type of revision joint replacement is most suitable for you. Whether to implant a “short” or “long” hip replacement, for example, is a decision that the surgeon may only make during the actual operation.

High-grade materials for prosthetic joints

  • Metals such as titanium and cobalt-chromium possess long-term stability, are biocompatible and have a proven track record stretching back decades
  • Special plastics have excellent sliding and friction properties
  • Ceramics are extremely hard-wearing and biocompatible

Replacement joints can be fixed in the bone either with or without bone cement. What technique the surgeon uses for the revision depends in part on how your first replacement joint was implanted. The surgeon always attempts to conserve as much healthy tissue and bone as possible. He will decide on a case-by-case basis whether your revision joint replacement should be implanted with or without bone cement. Implants fixed with cement are suitable principally for patients with poor bone vitality. 

MP® Reconstruction prosthesis (cementless)

Die MP® Rekonstruktionsprothese von LINK implantieren Ärzte, wenn sich die alte Endoprothese gelockert hat und dadurch Knochen verloren gegangen ist. Auch nach einem Knochenbruch im Bereich der alten Endoprothese wird oft die „MP®“ von LINK implantiert. Das Besondere an der „MP®“ ist ihr modularer Aufbau. Dadurch kann sie der  Anatomie des Patienten optimal angepasst werden. Ärzte schätzen an der „MP®“ zudem, dass sich die Beinlänge und die Beinstellung des Patienten damit gut korrigieren lassen. Der Schaft der „MP®“ hat eine speziell modifizierte Oberfläche. Dadurch kann nach der Implantation der Knochen optimal an die Endoprothese „anwachsen“ und eine langlebige stabile Verbindung von Knochen und Prothese
herstellen.

SP II® Long-stem prosthesis (cemented)

Eine LINK® SP II® Langschaft-Endoprothese implantieren Ärzte ebenfalls, wenn die bisherige Hüftendoprothese auszutauschen ist. Operateure schätzen an der „SP II®“ vor allem, dass sie der Anatomie des Oberschenkelknochens optimal angepasst und in mehreren Schaftlängen erhältlich ist. Die überdurchschnittliche Schaftlänge und der Einsatz von Knochenzement sorgen für eine stabile und langlebige Verankerung im Knochen.

LINK® Endo-Model®

Die LINK® Endo-Modell® Rotations- und Scharnierknie-Endoprothese – so der offizielle Name – ist eine seit Jahrzehnten bewährte Knieendoprothese, die Operateure weltweit nicht nur in besonders schwierigen Fällen einsetzen. Das „Endo-Modell®“ hat einen inno-vativen und sicheren Gelenkmechanismus, der Patienten nach der Operation eine hohe Stabilität im Kniegelenk sowie einen sicheren Gang und Stand ermöglicht.

Operateure können zwischen zementierbaren und zementfreien Varianten sowie mehreren Schaftlängen wählen. So kann die Endoprothese den anatomischen Gegebenheiten des Patienten optimal angepasst werden. Das Endo-Modell® kann mit den Modulen des LINK® MEGASYSTEM-C® verbunden werden (siehe unten).
 

LINK® MEGASYSTEM-C®

Das „MEGA-C“ ist ein Endoprothesensystem, das aus zahlreichen Modulen aufgebaut ist und Operateuren dadurch besonders viele Variationsmöglichkeiten bietet. Operateure können mit dem „MEGA-C“ selbst sehr große Knochendefekte überbrücken. Wenn es die Situation erfordert, können mit dem „MEGA-C“von der Hüfte bis zum Knie alle Knochen und Gelenke ersetzt und in schweren Fällen dadurch auch eine Amputation des Beines verhindert werden.

Revision acetabular cups

Wenn bei einer Wechseloperation der Schaft und die Hüftpfanne der bisherigen Endoprothese ausgetauscht werden müssen, können Operateure auf zementierte und zementfreie „normale“ Wechselpfannen zurückgreifen.

Hat der Patient im Bereich der Hüftpfanne jedoch einen größeren Knochendefekt, stehen den Ärzten besonders gut stützende Implantate zur Verfügung. Sie können der Anatomie der Hüfte angepasst sowie besonders fest und stabil im Beckenknochen verankert werden.
 

Every artificial joint and revision joint is the product of state-of-the-art precision engineering and craftsmanship.

Nevertheless, even the wide range of standard implants do have their limitations. For example, if all the bones in a patient’s thigh have to be replaced, or if a tumor causes a particularly large bone defect. Often, in such cases, the only way in which the patient’s mobility can be preserved is with a custom-made implant.
In close collaboration with the surgeons, customized replacement joints and revision replacements are designed by engineers at LINK and custom-made in Germany.

At the surgeon’s request, the surface of replacement joints and revision replacements can be specially coated or modified.

  • Innovative, microfine coatings or surface modifications are used to promote rapid bone ongrowth into the surface of the replacement joint. This enables the artificial joint to be anchored in the bone with long-term biological stability.
  • LINK PorEx® surface modification
only contains titanium and niobium
which are classified as non-critical for allergies. “LINK PorEx®” is therefore suitable for patients with a suspected metal allergy.  


Surgeons perform joint operations with instruments specially developed for that purpose, so usually only small incisions need to be made. This helps to conserve the muscles and bone, so you are back on your feet
quite quickly after the operation. You too can play a role in making your revision operation a success:

  • Ensure that you are in the best possible health when you arrive at the clinic. The healthier you are, the smoother the operation and subsequent healing will be.
  • Tell your physician what prescription and over-the-counter medication you are taking. Your physician also needs to know about any other health issues, such as allergies and infections - especially in the mouth, nose, throat, teeth, skin or nails.
  • You should do muscle-building and/or gait training. This will create the optimal conditions for your revision operation.
  • Discuss with your physician the option of donating your own blood for the operation, and also whether you need to lose weight.


Check list for your consultation

  • How are you feeling? Do you feel healthy?
  • What medication are you taking?
  • Would you like to donate your own blood for use in the operation?
  • Would you like to take part in muscle-building and/or   
  • gait training?
  • Do you need to lose weight?

Like most patients, you may be able to stand up again just a day after your operation. However, you still need to be careful. Your physician knows which movements you should avoid and whether you should use crutches.
Rehab at a clinic or at an out-patient center begins a few days after the operation. Training will make your muscles stronger each day, and this will help to stabilize your revision joint replacement. You then have every prospect of being able to walk pain-free and without crutches just a few weeks after the operation, like most patients.

  • Gehen Sie zu allen Nachuntersuchungen.
     
  • Halten Sie ein gesundes Körpergewicht.
     
  • Treiben Sie regelmäßig angepassten Sport, damit Ihre Muskeln kräftig bleiben.
     
  • Geeignete Sportarten sind leichte Gymnastik, Wandern in ebenem Gelände und Radfahren mit einem Rad mit tiefem Einstieg (leichtes Auf- und Absteigen).
     
  • Auch Schwimmen kann mit einer Knie- oder Hüftendoprothese erlaubt sein – am besten im Kraulstil.
     
  • Betreiben Sie keine Sportarten, die wie Tennis oder Squash viele Stoßbelastungen oder ein hohes Risiko für Verletzungen beinhalten.
     
  • Sprechen Sie zur Sicherheit mit Ihrem Arzt, wenn Sie bei einer Sportart im Zweifel sind.
     
  • Vermeiden Sie schwere körperliche Arbeit und suchen Sie bei Problemen umgehend einen Arzt auf.
     
  • Beseitigen Sie in Ihrem Wohnbereich Stolperfallen wie zum Beispiel lose Teppichränder.