Hip and Knee Total Joint Replacement Revisions – An Overview
by Dr. Douglas Miller, OSMS Hip and Knee Replacement Specialist

Dr. Douglas Miller’s expertise lies in partial and total knee replacement, anterior and posterior hip replacement, as well as revision of total joint replacements that have failed.

According to the American Academy of Orthopedic Surgeons (AAOS), total hip and knee replacement procedures are expected to grow by 171% and 189% respectively by 2030. There are many factors that contribute to this prediction, including elderly individuals maintaining an active lifestyle, people requiring joint replacement at a younger age and an increase in demand for joint replacement with the baby boomer population getting older.

Once a patient has a total hip or knee replacement performed, the new prosthetic joint can last anywhere from 20-30 years depending on a multitude of factors including activity level, weight, implant properties and position. Newer technology and implant design can certainly increase the longevity of the prosthesis.

With patients having total joint replacements performed earlier in their lives, a second surgery, called a joint revision surgery, may be recommended. Revision surgery may include removing and replacing the old joint replacement entirely, or exchanging some components.

The AAOS predicts that hip and knee revisions will grow by 142% and 190% respectively by 2030. But what are the benefits of a hip or knee revision, and how do you know when you might need one?

Hip Revisions

There are several reasons why a patient might need a total hip revision:

  1. Wear, loosening or breakage of the prosthetic
  2. Infection of the total hip replacement
  3. Repetitive hip dislocation
  4. Fracture around the prosthesis

When patients undergo a total hip replacement, they check in with their orthopedic surgeon regularly to make sure their new joint is in good condition. A patient should seek evaluation if they are having ongoing pain with sitting, sleeping or if their everyday activities are disrupted by the hip pain

Benefits of a total hip revision include:

  • Pain relief
  • Improved mobility
  • Better function

Knee Revisions

A patient might need a total knee revision due to:

  1. Wear, loosening or breakage of the prosthetic
  2. Infection of the total knee replacement
  3. Instability of the knee
  4. Stiffness of the knee

As with a total hip revision, your orthopedic surgeon will determine if you need a total knee revision during an exam. A patient with a painful knee replacement should be evaluated if they have recurrent swelling, instability, activity related pain or pain at rest.

Benefits of a total knee revision include:

  • Pain relief
  • Improved mobility and function
  • Improved range of motion

After your hip or knee revision surgery, you will likely be encouraged to attend physical therapy sessions to restore function. A physical therapist will help you begin walking and let you know what positions to avoid to prevent dislocation or injury to the surgical site.

Most importantly, having a painful total hip or knee replacement does not guarantee that you will need a hip or knee revision surgery. Unfortunately, 20% of patients continue to have pain following hip or knee replacement. Factors such as age, activity level, health history and more will determine the best treatment plan for you.

With total joint replacements on the rise, revisions will follow. If you have had a total hip or knee replacement and are struggling with pain, mobility and function, request an appointment with Dr. Miller for full evaluation of your painful total joint replacement.