How to Prepare for Revision Surgery

You’ve already had a joint replacement. Now your surgeon has recommended another surgery on the same joint because it has become stiff and painful again. It may even feel unstable, making it hard for you to participate in daily activities.¹

You may be wondering why this has happened, especially since primary joint replacement surgery is a very successful medical procedure. In most cases, it relieves pain and allows you to live a more active life. Sometimes, though, there are complications with joint replacement surgery that require re-operation. There are a number of possible reasons for this, including implant loosening, infection, damaged ligaments, or just normal wear and tear.¹ If you’re experiencing any of these problems, your surgeon may recommend a second surgery, known as a revision.

Implants can wear out over time, even in the absence of additional injury. As time passes, the possibility of needing a revision becomes greater. Patients who have had joint replacement at a younger age may outlive their original joint and need another.

Since you’ve already had primary joint replacement, you have a good idea of what to expect from a revision procedure. Still, facing surgery can be scary. Knowledge might help calm your fears, so never hesitate to ask questions. Here are some general questions to ask your doctor:³

• Why do I need revision surgery?
• Will losing weight or physical therapy alone help my condition?
• What is the success rate of this type of surgery?
• After surgery will my mobility be limited? For how long?
• How long will it take to recover?
• Will my pain subside after I’m fully recovered?
• What activities can I do? What should I avoid?
• What are my chances of needing another revision in the future?

There are certain steps you will need to take to get ready for your revision procedure. They may seem familiar to you, because many are the same for both primary and revision joint replacement surgeries.¹

• Have a medical evaluation by your primary care doctor to be sure you are healthy enough for surgery.
• Complete imaging and lab tests as ordered by your doctor.
• Ask a family member or friend to help you at home after surgery, or make arrangements to stay at a rehabilitation center. Your care team can help you with this if needed.
• Prepare your home by stocking up on items you will need (food, medications, etc.) and put them in easy-to-reach places.
• Find out what your insurance or Medicare will cover.

During a revision procedure, your surgeon will remove some, or all, of your original components and likely replace them with new ones. Damage to the bone may require your doctor to use specialized implants for extra bone support and specialized tools to achieve a good result.¹

The recovery and rehabilitation process after revision surgery is generally the same as for primary joint surgery. You will most likely require rehabilitation following surgery, which may include home health care, an outpatient recovery facility, physical therapy, and/or other forms of rehabilitation.⁴

Because revision surgery may take longer and is more complex than primary joint replacement, there is a greater risk of complications. Discuss these and any possible risks with your surgeon and ask about taking any specific measures to help avoid them.¹

Both primary and revision joint replacement have the same goal – to relieve pain and restore function. The good news is that most revision surgeries are successful and can lead to years of activity and good joint function.² However, replacement joints are still artificial and you need to be prepared for potential complication, including infection, anesthetic complications, loosening, fracture, wear, blood clots and other issues, all of which you should discuss with your surgeon.

1. Cross, M. (2015, May). Revision Total Knee Replacement. OrthoInfo from AAOS. https://orthoinfo.aaos.org/en/treatment/revision-total-knee-replacement/
2. DeVries, C. (2016, Jun 15). When is Joint Revision Surgery Needed? Arthritis-Health blog. https://www.arthritis-health.com/blog/when-joint-revision-surgery-needed
3. Revision Hip Surgery (2019, Oct 31). Cedars-Sinai. https://www.cedars-sinai.org/health-library/diseases-and-conditions/r/revision-hip-surgery.html
4. Hip Revision (2019, Nov 12). IU Health. https://iuhealth.org/find-medical-services/hip-revision