5 Common Reasons for Revision Joint Replacement Surgery

Key Takeaways

• Most joint replacements offer lasting relief, but they can sometimes wear out or develop complications over time.
• The five most common reasons for revision surgery include mechanical loosening, infection, instability or dislocation, wear and tear, and fracture.
• Revision surgery is more specialized and complex than an initial procedure, requiring advanced surgical expertise.
• Dr. Kyle Stoops is a fellowship-trained orthopedic surgeon in the Indianapolis area who specializes in complex revision joint replacements. To explore your options, you can request an appointment with his compassionate team.

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Understanding Revision Joint Replacement

Each year, joint replacements help bring pain relief and renewed mobility to hundreds of thousands of people. The implants used in these procedures are designed to be durable, but they are not meant to last forever. When a hip or knee replacement begins to fail, a second surgery may be needed to fix the problem.

It can be unsettling to learn that your implant needs to be replaced. Understanding why this happens can help you feel more informed and prepared for the path ahead. With a caring and skilled specialist like Dr. Kyle Stoops, you can find clear answers and a solution to get you back to a comfortable life. Let’s walk through the five most common reasons why a revision surgery becomes necessary:

1. Mechanical Loosening

The most common reason for a revision surgery is what’s known as “aseptic” or mechanical loosening. This means the bond between the implant and the bone has started to fail, without an infection being present. When your original joint replacement was done, the components were either cemented into place or designed for your bone to grow onto them, creating a solid connection.

Over many years of use, tiny movements and stress can gradually weaken this bond. As the implant loosens, it can move slightly against the bone, causing pain and a feeling of instability. This is not due to anything you did wrong; it is simply a mechanical process that can happen over time. During a revision, the surgeon removes the loose implant and secures a new one, re-establishing a stable foundation for the joint.

2. Infection

While not as common, an infection in a joint replacement is a very serious problem that almost always requires a revision surgery. An infection can happen shortly after the initial surgery, or it can develop years later if bacteria from another part of your body travels through your bloodstream and settles on the implant.

The signs of an infection can include new pain, swelling, warmth, and redness around the joint. You might also have systemic symptoms like a fever or chills. Treating an infected joint replacement is often a two-stage process. First, the surgeon removes the original implants and thoroughly cleans the joint, placing a temporary spacer that contains antibiotics. After the infection has cleared, a second surgery is performed to place a new, permanent revision implant.

3. Instability or Dislocation

A successful joint replacement should feel stable and secure. Instability occurs when the soft tissues around the joint, like the ligaments and muscles, are not able to support the implant properly. This can cause the joint to feel wobbly, or like it might 'give way.' In a hip replacement, severe instability can lead to a dislocation, where the ball of the implant comes out of the socket.

Instability can happen for several reasons, including improper implant positioning during the initial surgery, weakness in the surrounding muscles, or damage to the soft tissues. A revision surgery can correct this by repositioning the components, using a different type of implant that offers more stability, or repairing the surrounding soft tissues to provide better support for the joint.

4. Wear and Tear

Modern joint replacements are made of very durable materials, like metal alloys and a strong plastic called polyethylene. The plastic component acts as a smooth, gliding surface between the metal parts. Over many years and millions of steps, this plastic liner can gradually wear down, similar to how the tread on a tire wears out.

As the plastic wears, it creates microscopic debris particles. The body’s immune system can react to these particles, causing an inflammatory response that can dissolve the bone around the implant—a process called osteolysis. This can lead to the loosening of the implant. In a revision surgery, the surgeon can replace the worn-out plastic liner and, if needed, address any bone loss that has occurred.

5. Fracture

A fracture of the bone around the implant, known as a periprosthetic fracture, is another reason a revision may be necessary. This can happen because of a fall or other traumatic injury. It can also occur if the bone has been weakened over time by osteolysis.

Treating a fracture around an existing implant is complex. Sometimes, the fracture can be fixed with plates and screws while leaving the implant in place. However, if the fracture has caused the implant to become loose, a revision surgery will be needed. During this procedure, the surgeon will remove the original implant, fix the fracture, and then insert a new, often longer-stemmed revision implant that can bypass the fractured area and provide stability.

The Role of Advanced Technology: Spotlight on Enovis

When it comes to revision joint replacement, having access to the latest technology can make a meaningful difference in both outcome and recovery. Enovis is a leader in innovative orthopedic solutions, providing specially designed implants and surgical systems that support complex revision procedures.

For hip revisions, the EXPRT Revision Hip system from Enovis offers added stability and adaptability to address the unique challenges that arise when replacing an existing implant. This system is engineered to fit a wide range of patient anatomies and support surgeons in achieving a secure, long-lasting result.

In knee revision surgeries, the EMPOWR Revision Knee provides a reliable option for rebuilding stability and function. This advanced system is designed for durability and offers surgeons flexibility to address various causes of knee implant failure, from instability to bone loss.

By partnering with orthopedic experts who use forward-thinking technologies like those from Enovis, you’re taking another step toward a safer, more successful revision surgery.

Finding the Right Specialist for Your Revision

Revision joint replacement is a more complex and challenging procedure than a primary surgery. It requires a high level of skill, experience, and specialized training. That is why it is so important to find a surgeon who focuses on these types of cases.

Dr. Kyle Stoops is a fellowship-trained orthopedic surgeon with extensive expertise in complex hip and knee revisions. He understands the nuances of why joints fail and is skilled in the advanced techniques required to fix them. He is dedicated to providing his patients with not only exceptional surgical care but also the compassion and support needed to navigate this journey. Dr. Stoops believes in taking the time to explain the problem and the proposed solution, helping you feel confident and cared for.

Your Next Step Toward a Solution

Learning that you may need another surgery can be tough, but it is often the most effective path back to a pain-free life. Understanding the reason for your implant’s failure is the first step in the process. An evaluation with an experienced specialist is the best way to get a clear diagnosis and a personalized treatment plan.

If you are experiencing pain or problems with your hip or knee replacement, we invite you to request an appointment with Dr. Kyle Stoops. A thoughtful conversation can provide the answers you need and put you on the path to recovery.

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