Failed Hip & Knee Replacement
What is a failed hip or failed knee replacement?
Most total hip replacements and total knee replacements last patients for decades and often for their lifetimes. In rare instances, it’s possible that a hip or knee implant will fail, requiring further surgery. There are many causes for implant failure, each of which is fortunately infrequent. These situations can occur within weeks of a hip or knee replacement surgery, or many years later. For example, a patient may experience multiple dislocations of a hip joint prosthesis or problematic loosening from the bone of a total knee replacement. Falls can result in fractures around both hip and knee replacements. Normal wear of the prosthetic joint can occur over time, too. Failed hip replacement and failed knee replacement can result in severe pain and discomfort, and should be treated by a surgeon who is specialized in revision, or “redo”, hip and knee joint replacement.
What causes a failed hip or knee replacement?
While the majority of joint replacements are successful for 15-20 years or more, hip and knee replacement failure can occur due to a variety reasons, such as:
- Infection of the joint replacement (periprosthetic joint infection)
- Loosening of the implanted joint (aseptic loosening)
- Bone loss (osteolysis) or bone breakage (periprosthetic fracture) that disrupts the function and/or fixation of the implanted joint
- Weakening of the soft tissues surrounding the implant, whereby they lose the ability to support the joint (instability)
- Stiffening of the soft tissues around the implanted joint (arthrofibrosis)
Who is at risk for a failed hip or knee replacement?
There are many factors that can contribute to the failure of a hip or knee replacement, requiring revision joint replacement surgery. Some common risk factors include:
- Having a prosthetic hip or knee implanted for many years
- Having a hip or knee implant made from outdated materials that wear out faster
- High activity levels
- Heavy lifting
- Excess weight
- End-stage kidney disease, particularly if dialysis is required
- Susceptibility to infection (for example, patients with solid organ transplants)
- Cognitive impairment (for example, Alzheimer’s dementia)
- Neurological disorder (for example, Parkinson’s disease)
- Susceptibility to falls
- Predisposition to thick scar formation (for example, keloid formers)
In very rare cases, the original hip or knee replacement may not have been performed properly and never provided expected function for the hip and knee joint.
What are the symptoms of a failed hip or knee replacement?
Symptoms of a hip or knee implant failure may include:
- Unexplained swelling around the joint
- Significant pain at rest
- Increased pain during activity
- Feeling that the joint has dislocated or is loose
- Popping or scratching noises
- Sensation of abnormal movement in the joint
- Sensation that the leg gives out
- Decreased joint function
- Poor range of motion
- Inability to place weight on the leg
How are failed hip & knee replacements diagnosed?
If you are experiencing any of the above symptoms, or if you believe you may be suffering from a failed knee or hip replacement, you should consult with a revision joint replacement specialist. The work-up will start with Dr. McLawhorn asking you a series of questions to better understand your current health and the history of your joint replacement. In addition to a medical history, a thorough physical evaluation will be performed. X-rays are typically required to evaluate the implanted joint and to determine whether your symptoms are being caused by problems with the hip or knee implant. Additionally, advanced imaging like CT and MRI may be recommended. Blood work and sampling of the fluid around the joint replacement are commonly required to evaluate the cause of failure.
Bringing all prior health records and imaging of the joint is extremely valuable in determining the cause of joint replacement failure and helps Dr. McLawhorn provide the best solution to your problem.
How are failed hip & knee replacements treated?
Dr. McLawhorn is committed to personalized care for all of his patients, using evidence-based methods and nonsurgical treatment options whenever possible. In instances of minor joint replacement dysfunction, nonsurgical treatments may be recommended to minimize your symptoms such as:
- Activity modification
- Physical therapy
- Bracing the joint for added support
- Taking non-steroidal anti-inflammatory medications
However, when there is complete implant failure, revision joint replacement surgery may be the best treatment option in order to achieve successful restoration of function and resolution of pain. The solutions required for failed hip and knee replacements are often complex. Dr. McLawhorn has extensive experience with hip revision surgery and knee revision surgery.
If you believe you may be suffering from a failed hip or knee replacement, it is important to seek advice from an orthopedic joint replacement specialist to accurately diagnose and treat your condition. Dr. McLawhorn is a hip and knee replacement specialist at Hospital for Special Surgery serving patients in New York and Connecticut, with extensive training in diagnosing and treating failed joint replacements, including complex cases that require revision joint replacement surgery. To learn more, call 203-705-2113 (CT) / 212-606-1065 (NYC) today or schedule an appointment by using the form on this page.