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A joint replacement that still hurts, keeps dislocating, or has become stiff deserves proper investigation. Dr. Vaibhav Bagaria performs revision joint replacement in Mumbai at Sir H. N. Reliance Foundation Hospital, for knee and hip replacements that have loosened, worn, become unstable or become infected.
The first step is establishing exactly why the replacement is not working, because the right operation depends entirely on the cause.
This is the most important part of the process. A painful joint replacement has several possible causes, and some are not mechanical at all. Hip arthritis and lumbar spine problems can both refer pain to the knee. Spine problems can also cause pain in the buttock and thigh and may be mistaken for a failing hip replacement.
Thorough investigation is what makes revision surgery successful, because it ensures the operation addresses what is actually wrong.
Assessment comes before revision. Understanding the source of pain, instability or stiffness allows the surgical team to choose the appropriate treatment rather than assuming that every painful replacement needs to be revised.
The implant loses its fixation to bone over time. This is one of the more common reasons for revision.
The bearing surface wears with use over many years, and wear particles can affect the bone around the implant.
A knee that gives way or a hip that dislocates repeatedly may require revision to restore stability.
Infection can develop early after surgery or years later, sometimes following bacteria travelling through the bloodstream.
Scar tissue can restrict movement and make an otherwise implanted joint difficult to use.
Components positioned outside the intended range can affect movement, stability and function.
A fracture around an existing hip or knee replacement, often after a fall, may require revision and fracture fixation.
The team will establish when the original surgery was performed and by whom, whether the joint was ever comfortable, how the symptoms began, any wound problems afterwards, recent infections or dental work, and whether there have been any falls.
Assessment includes movement, stability, alignment, leg length, walking pattern, wound and scar assessment, and examination of the joints above and below.
Bring your original operative records if you can. Knowing exactly which implant was used shapes the surgical plan and the instruments needed, and it is worth requesting them from the hospital where your first operation was done.
Revision surgery is for patients whose knee or hip replacement is no longer working as it should, once investigation has established why.
Revision is generally the right step when:
Where investigation points to the spine or another joint as the source of symptoms, treating that is what resolves them which is why the assessment comes first.
Removing and replacing one or both components, often using implants with longer stems and additional stability compared with a first replacement.
Where only the plastic bearing is worn and the fixed components remain securely attached, a smaller procedure may be enough.
Where infection is confirmed, the implant is removed and the infection treated, often with a temporary spacer in place. A new implant is inserted at a second operation once the infection has cleared.
Augments, structural grafts or reconstruction cages may be required where the bone deficiency is significant.
Where bone loss is extensive and standard components cannot reconstruct the anatomy, custom implants can be planned and manufactured for the individual case, using the 3D-printing technique for which Dr. Bagaria holds a patent.
Where the bone has broken around the implant, revision may be combined with fixation to restore stability.
Outcomes are generally good where the cause has been clearly identified and addressed, which is why the assessment stage matters as much as the operation.
Most patients gain meaningful improvement in pain and function. Recovery takes longer than after a first replacement, and your surgeon will set expectations specific to your reconstruction.
Revision surgery is more individualised than first-time replacement. The extent of reconstruction, bone quality, implant choice and rehabilitation all influence the recovery process.
Failed knee replacement
Failed hip replacement
Post-traumatic arthritis
Medical Disclaimer: This page provides general information about revision joint replacement and is not a substitute for individual medical consultation. Revision surgery requires thorough investigation to identify the cause of failure before any operation is planned. Recovery timelines given here are typical ranges. If your replaced joint becomes hot, red and severely painful with fever, or you cannot bear weight after a fall, seek urgent medical evaluation.
Book a consultation with Dr. Vaibhav Bagaria and discover if robotic knee replacement is right for you.
Dr. Vaibhav Bagaria is Director and Head of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, and one of the earliest surgeons in India to adopt robotic joint replacement. Over twenty-two years of practice he has treated patients across the full range of bone and joint conditions, with a particular focus on robotic knee and hip replacement, partial knee replacement, sports injury and arthroscopy, and complex pelvic and acetabular reconstruction.
Name
Dr. Vaibhav Bagaria
Experience
20+ Years
Qualifications
MS (Ortho) FASSI, FNUS, FNAMS..
Speciality
Practice
