Revision Surgery After Total Joint Replacement

Pain and loss of mobility in the joints of the leg due to arthritis can be debilitating. Hip or knee replacement surgery can alleviate this pain and restore function. However, there are replaced knee or hip joints that eventually fail, causing problems. Infection, wear and tear, and injury can result in the need for revision surgery.


What Is Revision Surgery?

A revision hip or knee replacement surgery is when a patient needs to have a new procedure performed on a hip or knee that has already been surgically replaced. Depending on what the specific problem is, the entire prosthesis may need to be replaced, or just portions of it. 


One reason a replaced joint may need revision surgery is if loosening has occurred. During the original replacement surgery, the prosthesis may have been cemented in place, or it may have been pressed into place to allow the patient’s bone to grow into it over time. Loosening of the implant can be caused by the bone not growing into the implant as expected, due to repeated high-impact activity or excessive body weight. The result can be pain and swelling in the affected area or pain when moving the replaced joint.


Infection can also occur immediately after surgery or at any point later in the patient’s life. A bacterial infection can move from one part of the body to the implant, where the bacteria adhere to the metal components and can be difficult to remove. 


If an infection occurs soon after surgery, a joint washout can be performed, during which the hip or knee is surgically reopened and thoroughly cleaned. If the infection occurs further out from the original surgery, the treatment becomes more complicated. The entire implant may need to be removed, antibiotic treatment initiated to clear the infection, and a temporary implant would be put in place. Once the infection has resolved, another surgery would be performed to insert a new implant.


If the original hip or knee replacement surgery was performed on a young, physically active patient, the surgery may need to be revised due to early implant failure. Also, if an injury takes place that results in a broken bone near the joint, revision surgery may be required.


If you have a history of hip or knee replacement and are having pain or issues with the replaced joint, you should be evaluated by an orthopaedic surgeon with specialized training in revision joint replacement surgery

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