Revision Surgery for Hip and Knee

Revision Surgery for Hip and Knee Replacement with Dr. Kenneth Kleist

If you’ve already had a hip or knee replacement and you are not completely satisfied with your quality of life or functional abilities because of pain, stiffness, instability, or continued swelling, it would be a good idea to have your hip or knee re-evaluated.

Anatomy
The hip joint is a “ball-and-socket” joint.  The socket is formed by the acetabulum, which is part of the pelvic bone.  The head of the femur (thigh bone) attaches into the socket to form the ball portion of this joint. 

The knee joint involves the femur, the tibia (shin bone), and the patella (knee cap).

The original hip and knee replacement components are made of metal, plastic or ceramic.  With hip and knee revision surgery, the surgeon needs to remove any damaged components and replace them with new ones.   

Causes
Hip and knee revision surgery is often required due to components that have become damaged over time due to normal wear and tear or from damage caused by an infection.  Revision surgery is needed in these cases to correct these problems so the hip and knee joint can function normal again.

Symptoms
Common symptoms of hip and knee replacements that may require revision surgery include:

• Instability of the hip or knee joint
• Chronic pain and swelling of the hip or knee joint
• Long term stiffness of the hip or knee joint

Diagnosis
Further imaging and lab studies are commonly used to help confirm the underlying problems.  Ultimately, we take the time to go through your entire history and leave no stone unturned before considering revision surgery because it can be a much more complicated process and procedure than primary (first time) surgery. 

Recovery
Recovery from revision surgery is similar to the recovery from the primary (first time) surgery.  Post recovery in the hospital may take 1-3 days.  Patients are discharged from the hospital once their pain is well controlled, and they are able to demonstrate safe gait mechanics and functional transfers using their assistive device.  Typically, a patient will require some help from family and friends once home.  

Treatment
Each individual will receive care that is unique to them.  Progression of range of motion, weight-bearing stats, strength exercises, and returning to functional activities is different for each individual.  Physical therapy will normally begin within 1-2 days of being discharged.  Rehabilitation takes on average 6-10 weeks, but varies by individual.

Prevention
Sometimes the above symptoms can be easily explained, the previous replacement is just fine, and we can develop a plan to improve your condition without further surgery.  Our fellowship-trained hip and knee specialists offer dedicated office appointments with more time spent face-to-face for people with concerns about their previous joint replacements, because these scenarios can be quite complicated.