About Complex Revision Joint Surgery
Although hip and knee joint replacement surgery is very successful, there continues to be a need for revision joint replacement surgery in cases where the artificial joint fails in some way, causing pain, mobility issues or other problems that require surgical intervention to correct. These procedures require careful pre-surgical planning and preparation in order to ensure the complications are resolved and the outcome is optimized for the patient’s needs.
Depending upon the type of failure that occurs, the previously implanted components either need to be completely or partially replaced. The bone around the damaged components is prepared using special techniques in order to help strengthen and reinforce them before inserting the new components. Added reinforcement is used when necessary to ensure the joint in stable and secure. Before revision surgery occurs, the joint will be carefully evaluated to ensure the best possible approach for resolution of the issues you’re experiencing.
Some of the most common reasons for joint revision surgery include infection, wear-and-tear of the artificial components over time, loosening or displacement of the components, joint instability or stiffness, persistent pain in the joint, and fractures of the bone surrounding the joint components (usually as the result of a fall). Because hip and knee joint replacements are prosthetic joints, they can wear out with time. For this reason, it is very important to see your surgeon every 1 to 2 years after replacement surgery for examination and radiographs.
Revision surgery requires special expertise and considerable experience in order to achieve the best possible results. Unlike initial joint replacement surgery, revision procedures require more complex techniques and a deep understanding of the methods used to reinforce joints that have been compromised by implant failures. With nearly 20 years of experience in total joint replacement and complex revision surgery, Dr. Randall Peyton has the knowledge to help restore your quality of life, using the most advanced techniques and technology to enable every patient to get the customized care necessary for the best possible outcome.
Frequently Asked Questions
Q: If my total hip or knee joint replacement ever fails, can it be done over?
A: YES! A highly trained specialist orthopedic surgeon (like Dr. Randall Peyton) who has completed a Total Joint Replacement Fellowship or has other advanced experience can re-do your joint. It is a more complicated procedure than primary arthroplasty, resulting in longer surgeries.
Q: Why is revision joint replacement more complicated?
A: After years of implant use, the remaining bone quality can be compromised, and special techniques are required to “rebuild” the bone supporting the new implants. Sometimes we use bone from cadavers (bone graft) or metal augments to rebuild the bone during a revision joint replacement.
Q: Is the recovery period for a revision longer than for the initial surgery?
A: Sometimes it is. Often crutches are needed to take weight off of the healing bone (particularly if the femur has been split). Sometimes the recovery is similar to a primary joint replacement, particularly if the re-do surgery involved only a plastic liner exchange. The possible complications are similar to primary joint replacement, although dislocation risk of hip implants is increased, and the infection rate is higher. This is mostly because more soft tissues are stripped from the bone during implant removal, and there is more bleeding.
Q: Can the joint be revised more than once?
A: Yes, and younger patients may have two or three replacement operations in their lifetime. Special implants are available that fit unique situations. Besides loosening from the bone, other possible reasons for revision include infection, implant breakage, osteolysis (bone loss from particle debris), and dislocation.