Revision Joint Replacement Surgery

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What is revision joint replacement surgery?

Joint replacement surgeries are successful in most cases, and can help patients regain mobility, reduce pain, improve their quality of life, and get back to their active lives. However, joint replacement surgery can fail for a number of different reasons, whether it’s within weeks of a hip or knee replacement surgery, or many years later. If a failed hip or knee replacement occurs, a specialist in revision joint replacement may recommend a second surgery, or “redo” or “revision” surgery, to correct the failed replacement.

Why is revision joint replacement surgery performed?

Revision of total hip replacements and total knee replacements are performed to fix failed hip and knee implants. The goal is to optimize joint function and relieve pain. Some conditions that may warrant revision joint replacement surgery include the following:

  • Implant loosening over time
  • Implant wearing over time
  • Fractures around an original joint replacement
  • Multiple joint dislocations
  • Excessive scar tissue around the original joint replacement
  • Unstable ligaments surrounding the knee
  • Infection of the original joint replacement

What does revision joint replacement surgery involve?

A revision hip or knee replacement procedure is typically quite complex and requires a great deal of pre-surgery planning. The problems requiring revision surgery usually require an individualized plan of care, but the general steps for failed hip and knee replacement surgery include the following:

  • Before surgery, x-rays, blood tests, aspiration of the joint for fluid, CT and/or MRI scans help determine the cause of implant failure and the best surgical approach for revision
  • During surgery, one or more or all of the previously implanted joint components will be removed, and bone grafts, metal augments, bone cement, and/or screws may be used to strengthen the remaining bone and fix new components to your remaining bone around the joint
  • After surgery, patients go through many of the same recovery steps as they did with their primary total hip replacement or total knee replacement surgery
  • It is possible that you may not be allowed to place your full weight on the revision implant for several weeks after surgery
  • In cases of severe infection, a two-stage revision may be required. During the first stage, the entire prior joint replacement is removed and an antibiotic spacer is inserted into the joint. Approximately 6 weeks of intravenous antibiotics are given. When laboratory testing confirms that the infection has been successfully treated, a second stage surgery is performed, during which the antibiotic spacer is removed and a revision-style joint replacement is inserted

What are the advantages of revision joint replacement surgery?

Some of the advantages to having revision joint replacement surgery include:

  • Favorable long-term results are seen in the vast majority of revision surgery patients
  • Increased stability and function of joint
  • Complete or near-complete pain relief
  • Relieved stiffness in joint

The outcomes and longevity for revision joint replacement are not always as good as they are for primary joint replacement. The risk for complications is also increased. Outcomes are dependent upon the reason for revision surgery, the health of the patient, and the necessary complexity of the reconstruction. Dr. McLawhorn provides patients with realistic expectations for their revision surgery on a case-by-case basis.

Learn more about what you can expect before and after surgery in Dr. McLawhorn’s FAQs.

If you are suffering from severe joint pain following a primary joint replacement and believe you may need revision joint replacement surgery, it is important to seek advice from an orthopedic specialist to accurately diagnose and treat your joint pain. Dr. McLawhorn is a hip and knee specialist at Hospital for Special Surgery serving patients in New York and Stamford, Connecticut. To learn more, call 203-705-2113 (CT) / 212-606-1065 (NYC) today or schedule an appointment by using the form on this page.

Learn more about revision knee replacement surgery at hss.edu

Learn more about revision hip replacement surgery at hss.edu

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