Most hip and knee replacements last for many years and never need further surgery. A minority, however, do eventually need to be revised. Mr Kosuge sees two groups of patients in this situation. Those whose original replacement, often done years ago, is beginning to wear or loosen and those who have ongoing pain after a replacement. This article explains what revision surgery is and when it is needed.
What revision surgery means
A revision is an operation to replace or repair some or all of an existing joint replacement. It is not a sign that the first operation was done poorly. Implants are mechanical and, like anything mechanical, they can wear or work loose over a long enough period. A revision restores the joint when that happens.
Why a replacement might need revising
There are several reasons. The most common is simple wear or loosening of the implant over many years. Others include instability, where the joint feels unreliable or dislocates, a fracture in the bone around the implant, and, less commonly, infection. Pain that comes on years after a replacement that was previously comfortable is always worth having assessed, because the cause can often be treated.
How revision differs from a first replacement
Revision surgery is more complex than a first, or primary, replacement. The original implant has to be removed carefully, the bone assessed and sometimes reinforced and a new implant chosen to fit the situation. It requires specific expertise and planning. The recovery can be a little slower than a primary replacement. The important point for patients is that, in experienced hands, revision surgery has good outcomes and can return a painful, failing joint to reliable function.
When to seek an opinion
The signs worth acting on are new or increasing pain in a replaced joint, a sense that the joint is unstable, swelling, or difficulty weight-bearing. An assessment usually involves an examination, X-rays and sometimes blood tests or further imaging. Seeing a specialist gives you a clear diagnosis and an honest account of the options, which may or may not involve surgery.
Arranging an assessment
Mr Kosuge assesses and performs revision hip and knee replacement and welcomes second opinions on replacements carried out elsewhere. To arrange a consultation at The Rivers Hospital, High Wych Road, Sawbridgeworth CM21 0HH, use the online booking page or call 01279 602675.
Telephone: 01279 602675