Ask the Doctor about Joint Replacement.

Do joint replacements ever fail? 

While joint replacement failures are rare, approximately 6% require revision surgery in the first five years (1) due to mechanical or biological causes.

Mechanical causes might include: hip dislocations, unstable knees, loosening of the implant where it meets the bone. Sometimes, wear and tear can result in the release of small particles, which can incite an immune system reaction ­— called osteolysis. Like any other mechanical device, hip and knee implants have a finite life cycle, usually 20-30 years, and as such have a service life like any other moving part.

Biological problems can include: infection of the new joint, failure of the implant to grow into the bone, and less commonly a metal allergy to the implant itself.

What is “revision joint surgery?”

A revision is a second surgery on an existing hip or knee replacement – often removing and replacing all or part of the artificial joint. Revision surgery is a valuable tool to help patients with a loose, unstable, painful, or misaligned implant. Pain or loss of function is often the initial symptom.

Revision surgery is much more complex than the initial joint replacement and requires specialized implants and surgical techniques to compensate for bone and ligament loss.

What are the risks of revision joint surgery?

Revision joint surgery is more technically complex than the initial hip or knee replacement. Therefore, these surgeries carry an increased risk of infection, damage to surrounding nerves and blood vessels, fracture, and a more involved recovery process. These risks can be minimized by choosing a surgeon and medical center that specialize in revision procedures.

Chris Mudd, MD, is a board-certified orthopedic surgeon and on staff at Missouri Baptist Medical Center. He earned his medical degree from St. Louis University School of Medicine. He completed a combined internship/residency in orthopedic surgery at St. Louis University Hospital and a fellowship in adult hip and knee reconstruction surgery at Cleveland Clinic Foundation.

 (1) J. Bone Joint Surg. 2011 Jul;93(7):998.

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