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Dr Lipalo Mokete, Specialist Arthroplasty Surgeon

Revision Joint Replacement (Repeat Surgery)

Joint replacements can fail for various reasons. The commonest cause of failure within the first year of implantation is infection of the joint. Late failure of the joint replacement is due to loosening of the parts, the joint starting to feel unstable or wear of the parts related to use. Revision joint replacement surgery is generally more complicated than the first operation. The duration of surgery tends to be longer and the parts implanted generally tend to be longer versions of parts used in first time operations. Bone graft (from a bone bank) may also be used to restore bone stock in instances where there has been extensive bone loss. Prepare for a longer hospital stay! The surgery is more extensive and you are older than at the time of the first operation. The rehabilitation process is similar but you may be required to use walking aids for a longer period to avoid putting your full weight through the operated leg.

Revision surgery for the infected joint replacement

If infection is recognized within the first month, it can be cleared by surgical removal of infected tissue and limited replacement of the parts without removing the entire replacement. This process would be followed by an extended course of antibiotics. Established infection can only be cured by surgical removal of infected tissue and all parts. The surgery is complex and is normally carried out as two separate procedures. In the first procedure, infected tissue and all parts are removed and antibiotic laden temporary space filler is implanted. This is followed by an extended course of antibiotic treatment as an inpatient. Only once the infection is cleared would we consider the second procedure, which involves implantation of revision joint replacement parts. The time period between the two procedures is two to three months.