Total Joint Revision Center
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Total Joint Revision Center
What is a revision?
A total joint revision is a procedure done when a total hip replacement or total knee replacement fails. It is essentially a "redo" of the first surgery. There are many different modes of failure for a hip and knee replacement. A failed surgery or implant can lead to significant pain and disability. Our surgeons are able to fix the smallest to largest problems and do complex revision surgery from all over the southeastern United States.
Front view of a revision total knee replacement
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Side view of a revision total knee replacement
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Why do knee replacements and hip replacements fail?
There are numerous reasons why hip and knee replacements can fail. A variety of factors must be assessed in order to delineate what he problem is with the joint. Patients may suffer from infections (less than 1%), failure of the plastic, implant failure, loosening after a fall, allergic reaction, wear of the plastic over many years, etc. When total joints fail, patients can be severely debilitated. Our group believes in identifying the problem, explaining the root cause of the problem, then addressing it to our patients satisfaction. From infection to breaking a bone around the implant, our surgeons are all capable of restoring your function! Turn no further, we're here to help. Click to fill out our surveys and let us review what's wrong with your hip replacement or knee replacement.
How do I know if my hip replacement or knee replacement has failed?
Infection
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to erradicate the infection and get you your life back!
Aligment Problems
In total knee replacements, poorly placed components with incorrect rotation can lead to knee stiffness. Our surgeons will take X-Rays and see if this is part of the problem leading to stiffness.
Plastic Wear
Think of the plastic in a knee or hip replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
Although rare with knee replacement, hip replacements can dislocate. There are multiple reasons for hip dislocations. The variables are the placement of the cup (socket), the femoral component (stem) and the approach taken to the hip. Classically, posterior hip replacement surgeons have higher dislocations. Although arguments are made against it by posterior approach surgeons, the data does not support them. Posterior hip replacements have a significantly higher rate of dislocation than an anterior based approach to the hip. Hip dislocations most commonly occur because of malpositioning as well as the surgical approach taken to the hip.
Stiffness
There are many reasons why a joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," where the knee or hip is placed through a range of motion to break up the scar tissue in the operating room.
Heterotopic Ossification
Albeit rare, after joint replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation why. However, this can be a significant source of stiffness and can severely limit patient mobility
Component Failure
Extremely rarely, the components may fail or dissociate. In this rare condition, the surgeon must replace these components.
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to erradicate the infection and get you your life back!
Aligment Problems
In total knee replacements, poorly placed components with incorrect rotation can lead to knee stiffness. Our surgeons will take X-Rays and see if this is part of the problem leading to stiffness.
Plastic Wear
Think of the plastic in a knee or hip replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
Although rare with knee replacement, hip replacements can dislocate. There are multiple reasons for hip dislocations. The variables are the placement of the cup (socket), the femoral component (stem) and the approach taken to the hip. Classically, posterior hip replacement surgeons have higher dislocations. Although arguments are made against it by posterior approach surgeons, the data does not support them. Posterior hip replacements have a significantly higher rate of dislocation than an anterior based approach to the hip. Hip dislocations most commonly occur because of malpositioning as well as the surgical approach taken to the hip.
Stiffness
There are many reasons why a joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," where the knee or hip is placed through a range of motion to break up the scar tissue in the operating room.
Heterotopic Ossification
Albeit rare, after joint replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation why. However, this can be a significant source of stiffness and can severely limit patient mobility
Component Failure
Extremely rarely, the components may fail or dissociate. In this rare condition, the surgeon must replace these components.
Is your hip replacement or knee replacement painful? Let us look into it more. Fill out our surveys and a team member will get back to you within 2 business days. Please note we can not make diagnosis over the phone and you will most likely need to schedule a visit.
