Revision joint replacement
Revision hip and knee arthroplasty
When a joint replacement needs attention
An evaluation may be appropriate if your hip or knee replacement:
- Has become increasingly painful, or never stopped hurting after surgery
- Feels loose or gives way when you walk
- Has dislocated, or feels as though it might (hip)
- Remains too stiff to bend or straighten enough for daily activities (knee)
- Swells frequently, or feels warm and looks red
- Drains fluid from the incision, or is accompanied by fevers
Common causes include loosening or wear of the implants, infection, imbalance of the soft tissues around the joint, and fractures of the bone near the implants.
Finding the cause
How your joint is evaluated
Surgery
What revision surgery involves
Revision surgery is more complex than a first joint replacement, and the surgical plan depends on the underlying problem.
Replacing worn or loose components
Sometimes only a single component needs to be exchanged, such as the plastic liner in a hip or the plastic spacer in a knee. In other cases, all of the implants are replaced. Specialized implants with longer stems, or augments that fill areas of bone loss, help restore strength and stability.
Treating infection
An infected joint replacement is often treated in two stages. In the first surgery, the implants are removed and replaced with a temporary antibiotic-loaded spacer, followed by several weeks of antibiotic therapy. Once the infection has cleared, new implants are placed in a second surgery. Some infections can be treated with a single operation.
Improving instability or stiffness
A hip that dislocates, or a knee that feels unstable or stiff, can often be improved by changing the size, position, or design of the implants.
Risks
Understanding the risks
Revision surgery carries a higher risk of complications than a first joint replacement. Potential problems include infection, blood clots, hip dislocation, knee stiffness or instability, delayed wound healing, and the possibility of further surgery in the future. We will review your individual risk factors with you and discuss how to reduce them.
Questions
Frequently asked questions
How do I know if my joint replacement has failed?
Increasing pain, swelling, a loose or unstable feeling, a hip that dislocates, or a joint that steadily worsens are all reasons to be evaluated. A careful examination, X-rays, and laboratory tests can usually identify the cause.
Does every painful joint replacement need another surgery?
No. Some causes of pain respond to therapy, medication, or other nonsurgical care. We recommend surgery when it is likely to help.
Can you treat a joint replacement performed by another surgeon?
Yes. Please bring your records, including the operative report and any X-rays from your original surgery.
How long does a revision joint replacement last?
Many revision hip and knee replacements last for many years. Longevity depends on the reason for the revision, the quality of the remaining bone, and your overall health.
Ready to talk about your hip or knee?
Book online or call to see Chibuzo Akalonu, MD at the Pearland or Houston office.