Orthopedic Revision Surgery

How to Know When It’s Time for a Tune-up

Thanks to advances in medical science, it’s easier than ever to be hip again.

We’re talking about your hips, not actually being hip.

Joint replacements have changed our lives for the better. Hundreds of thousands of hip and knee replacement surgeries are performed every year in the United States, helping people live without pain while restoring mobility and improving their quality of life.

But what happens if something goes wrong with your replacement parts? We’re here to answer your questions.

What is joint replacement?

During a joint replacement procedure, an orthopedic surgeon replaces arthritic areas of a joint with a metal, plastic or ceramic implant. The implants used in joint replacement won’t last forever, but they are good for up to 15 - 20 years.

What is revision surgery?

When a joint implant wears out, you may need a second surgery. During the procedure, the existing implant is taken out and replaced.

How would I know if I need a revision?

If you’ve had a joint replacement and experience pain that comes on suddenly, trouble getting around or less range of motion, it may be time to talk to your doctor about a revision procedure.

What causes an implant to go bad?

A variety of factors can cause a joint implant to wear out or not work correctly. This can include: 

• Loosening of the implant - A hip or knee replacement can become painful after several years when the components become worn or start to loosen.
• A fracture – Any type of fall or severe blow can fracture the bone near the hip or knee replacement.
• Dislocation – Just like when a bone pops out of a socket, an implant can become dislocated. If this happens frequently, a revision may be needed.
• Infection - If a deep infection develops in a hip or knee replacement, revision surgery is often needed to get rid of the infection and implant new non-infected parts.
• An implant recall - Occasionally, joint replacement impacts are found to be defective. Revision surgery might be needed if an implant is recalled.

Will revision surgery have the same results as a joint replacement?

A revision joint replacement doesn’t provide the same lifespan as the initial replacement. Revisions can usually last around 10 years. A revision procedure is typically more complex than the original knee replacement surgery because the surgeon needs to remove the original implant, which would have grown into the existing bone. Once that prosthesis is removed there is less bone remaining. In some cases, a bone graft (transplanting a piece of bone from another part of the body or a donor) might be needed to support the new prosthesis. A bone graft will add support and encourages new bone growth.

Are there complications from a revision procedure?

Complications from revision surgery are similar to those of a joint replacement and may include:  

• Deep vein thrombosis (a blood clot in a deep vein)
• Infection in the new implant
• implant loosening (especially if you’re overweight)
• dislocation of the new implant (the risk is twice as high for revision surgery)
• More rapid loss of bone tissue
• Bone fractures during the operation if the surgeon has to use force to remove the old implant
• A difference in leg length (a new prosthesis can shorten a leg)
• The formation of heterotopic bone, which develops at the lower end of the femur after surgery. 

Is there anything I can do to make my existing joint replacement last longer?

There are steps you can take to make your initial hip or knee replacement last longer and lessen the possibility of revision surgery, such as: 

• Avoid overusing the joint – Try to avoid high-impact activities, such as running and tennis, which can shorten the lifespan of the joint replacement. Try walking instead of running or try doubles instead of singles tennis.
• Avoid sports that require jumping and landing hard - These can weaken or damage the joint. Instead, engage in low-impact activities that build muscle strength.
• Maintain a healthy weight - Being overweight is one of the main factors in developing arthritis. People who are overweight are more likely to experience loosening of an implant.
• Stay on top of any unexpected pain - Once the initial healing has taken place, talk to your doctor if pain develops or returns suddenly.
• Take antibiotics for infections - If you develop a bacterial infection in another part of your body, make sure your doctor prescribes antibiotics.
• Stay in touch with your surgeon – Schedule an appointment with your orthopedic surgeon every few years after hip or knee replacement, even if the joint feels good. The physician can check for early loosening of the implant or other minor issues before they become a problem (such as dislocations).
  

Keep your knees and hips feeling new

If you’re concerned your joint replacement may require a tune-up, talk to your doctor. Although revision surgery is major surgery, the results can mean many more years of pain-free living.