Overview

Hip and knee replacements are designed to relieve pain and restore function when a damaged joint can no longer be effectively managed with nonsurgical treatment. Although joint replacements can provide many years of improved mobility, an artificial joint may eventually wear out, loosen or develop another problem that affects its function. This is commonly referred to as a failed joint replacement.

A failed hip or knee replacement does not always mean another operation is immediately necessary. Identifying the cause of new or worsening symptoms is the first step in determining whether nonsurgical care, continued monitoring or Total Joint Revision Surgery may be appropriate.

Symptoms & Causes

Pain is one of the most common reasons patients with a previous hip or knee replacement seek evaluation. Other possible symptoms include swelling, stiffness, instability, decreased range of motion, difficulty walking or bearing weight, and a change in how the joint feels or functions.

Several problems can contribute to joint replacement failure. Over time, implant components may wear or loosen from the bone. Other causes can include instability, fracture around the implant, implant positioning or mechanical problems, bone loss and Joint Replacement Infections. In some cases, more than one factor may be contributing to the patient's symptoms.

Affected Populations

Anyone who has undergone total hip or total knee replacement can potentially experience implant-related problems. Because artificial joints can function for many years, patients who had joint replacement at a younger age may have a greater lifetime likelihood of eventually needing revision surgery. Individual risk also depends on factors such as activity, implant condition, bone quality and overall health.

Diagnosis

Evaluation generally includes a review of the original joint replacement, current symptoms and medical history, followed by a physical examination. X-rays can help assess implant position, wear, loosening, bone loss or fractures. Additional imaging or laboratory testing may be needed when infection or another complication is suspected.

Treatment

Treatment is based on the underlying reason the replacement is causing problems. Some symptoms may initially be managed without surgery. When an implant is loose, worn, unstable, infected or otherwise unable to function properly, Total Joint Revision Surgery may be recommended.

Revision surgery may involve replacing one or more components of the original hip or knee replacement and addressing associated bone or soft-tissue damage. Because every failed joint replacement is different, careful evaluation and surgical planning are especially important.