Revision Joint Replacement

A revision joint replacement means that surgery must be done to replace a worn-out joint replacement. Also called revision arthroplasty, revision joint replacement is often more complicated than the initial joint replacement and the revision surgery may have less predictable results. People may refer to a revision joint replacement as a repeat joint replacement, or a replacement of a joint replacement. There is no limit to the number of revision replacements that can be performed, although they generally become more difficult each time.

X-ray graphic of a hip replacement
BSIP / UIG / Getty Images

Reasons a revision joint replacement may need to be performed include:

  • Worn-out implants: Over time joint replacement implants will eventually wear out. While developments in joint replacement materials are intended to make these implants last longer, they will eventually wear out. Most surgeons recommend patients avoid certain impact sports after joint replacement in an effort to ensure the implants last as long as possible.
  • Infection of a replaced joint: Infection is a serious complication of joint replacement surgery and often requires additional surgery. When the infection is found soon after the initial surgery (within weeks or months of the initial joint replacement) sometimes a revision replacement can be avoided. However, if the infection occurs more than 6 weeks after surgery, it typically requires a revision joint replacement, sometimes multiple operations, to cure the infection.
  • Instability of implants: All types of joint replacements are susceptible to instability—the implants not holding in the proper position, or dislocating completely from their normal position. In the case of hip replacement surgery, hip dislocation is a possible complication. Revision joint replacement can use specialized implants to help improve the stability of the joint.
  • Malpositioning of an implanted joint: Poorly positioned implants can cause a number of problems including accelerated wearing out of the implants, limited mobility of the joint, or instability of the joint. If the implants are not well positioned, a revision joint replacement can be performed to try to improve the function of the joint.
  • Painful joint replacement: Performing a revision joint replacement because of pain is controversial. Most surgeons agree, that the specific source of pain must be identified before considering a revision joint replacement. Performing a revision joint replacement without a known cause for the symptoms (such as a loose implant or infection) is unlikely to lead to good results. This is problematic for people who have joint replacements that look well-aligned, secure within the bone, and no obvious issue with the implant, yet the individual still has pain.

Because of the many different reasons a revision joint replacement may need to be done, every aspect of the surgery must be treated on an individual basis. Therefore, you must discuss these procedures at length with your surgeon. Not all revision joint replacements require the replacement of all parts of the implanted joint. In some cases, parts of the original implant may still be in perfect condition while others may need to be replaced.

Complexity of Surgery

Revision joint replacements are often a more complicated surgery because of scar tissue formation, loss of normal bone, and difficulty removing implants that are not loose. While the general risks of revision joint replacement are similar to a standard joint replacement, you should certainly discuss with your healthcare provider specific concerns with your surgery. Furthermore, it is important to discuss the expected outcome of surgery, as most often the expected results of revision joint replacement are not as optimistic as with a standard joint replacement.

Prior to performing revision joint replacement surgery, your surgeon is likely to obtain a number of different tests to evaluate the implants. It is important to know if the implants are loose or well fixed to the bone, if there is any chance of infection in the joint, and the condition of the bone around the implants. In addition, many hospitals will need to bring in special equipment at the time of revision joint replacement surgery.

While everyone wants to know how long a hip replacement will last or how long their knee replacement will last, it is important to remember that while there are averages, there are often very significant differences among individuals. Even though an average implant may last 15 or 20 years, some implants may last 30, while others may need revision surgery within a few years. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ranawat AS. Revision total knee replacement: frequently asked questions (FAQs). Hospital for Special Surgery.

  2. Lu J, Han J, Zhang C, Yang Y, Yao Z. Infection after total knee arthroplasty and its gold standard surgical treatment: Spacers used in two-stage revision arthroplastyIntractable & Rare Diseases Research. 2017;6(4):256-261. doi:10.5582/irdr.2017.01049

  3. Nikolaou VS. Common controversies in total knee replacement surgery: current evidenceWJO. 2014;5(4):460. doi:10.5312/wjo.v5.i4.460

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Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.