Revision Arthroplasty: When a Hip or Knee Replacement Needs a Redo

Most hip and knee replacements work well for many years. But if you’re experiencing pain, instability, stiffness, infection, or implant wear, you may need a revision arthroplasty - a procedure to repair, replace, or rebuild part (or all) of a previous joint replacement.

At Agile Ortho in Durban, our specialist surgeons provides comprehensive evaluation and treatment for failed or failing joint replacements, with a personalised plan focused on restoring function and confidence.

Why Might a Joint Replacement Fail?

Common reasons include:

• Aseptic loosening & wear/osteolysis (implant–bone interface weakens)

• Instability/dislocation (hip) or recurrent giving-way (knee)

• Periprosthetic joint infection (PJI) - acute or chronic

• Periprosthetic fracture around the implant

• Stiffness, malalignment, component failure, or leg-length/offset issues

Any of our doctors will explain which mechanism applies to you and how that guides treatment.

How Agile Ortho Evaluates a Painful or Unstable Joint Replacement

Your work-up is thorough and stepwise:

• History & examination targeting pain patterns, instability, gait, and function

• Imaging: standing X-rays; CT or EOS as needed for alignment/bone loss; occasionally nuclear imaging

• Infection screen: blood tests (e.g., inflammatory markers) and joint aspiration for cell count and cultures when indicated

• Function & goals: your activity level, work demands, and recovery expectations

This structured approach helps us distinguish between infection, loosening, malposition, soft-tissue deficiency, and other causes - each requiring a different solution.

Treatment Options at Agile Ortho

• DAIR (Debridement, Antibiotics, Implant Retention)
For selected early infections, urgent washout, modular liner exchange, and targeted antibiotics can salvage the implant.

• One-Stage Revision
In carefully chosen cases (adequate bone/soft tissue, known organism/susceptibility), removal and re-implantation occur in a single surgery, streamlining recovery.

• Two-Stage Revision
For chronic or complex infection, implants are removed and an antibiotic spacer is placed; after infection control, a definitive reconstruction follows.

• Complex Reconstruction for Loosening/Wear

Hip: options may include extended exposure, acetabular augments/cages, porous metal cups, long/revision stems, restoration of offset and leg length.

Knee: constrained or hinged implants as needed, stems, augments, metaphyseal cones/sleeves to manage bone loss and stability.

Goal: a stable, well-aligned joint with durable fixation and improved function.

What to Expect: Before, During & After

Before surgery

• Medical optimisation (diabetes, nutrition, smoking cessation)

• Physiotherapy “pre-hab” to build strength and balance

• Clear plan for home setup and support

Surgery day

• Anaesthesia plan tailored to you

• Removal of failing components, debridement, and reconstruction

• Use of stems, augments, or cones as needed to address bone loss and stability

Recovery

• Early mobilisation with physiotherapy

• Graduated weight-bearing per reconstruction type

• Close monitoring for wound healing and infection control

• Progressive return to daily activities and low-impact exercise

Risks & How We Minimise Them

All revision surgery carries risk: infection or re-infection, blood clots, fracture, nerve or vessel injury, stiffness, instability/dislocation (hip), leg-length difference, and implant loosening over time.


At Agile Ortho, our surgeons follow evidence-based protocols for infection prevention, blood clot prophylaxis, meticulous soft-tissue handling, and a structured rehab pathway to reduce complications.

Outcomes You Can Expect

While revision surgery is more complex than a first-time replacement, many patients achieve meaningful pain relief, improved stability, and a return to everyday function. Your exact outcome depends on the reason for failure, bone and soft-tissue quality, overall health, and adherence to rehab.

FAQs: Revision Arthroplasty at Agile Ortho

Do all painful joint replacements need revision?


No. Some issues respond to targeted physio, injections, or minor procedures. Our specialists will outline all appropriate options.

How long is recovery after revision compared with primary replacement?


Revision recovery is often longer due to complexity and bone loss management. Many patients progress over 6–12+ weeks, with timelines tailored to your reconstruction.

Is infection always two-stage?


Not always. Selected acute infections may be treated with DAIR; certain cases may qualify for one-stage revision. Your plan is individualised.

Can bone loss be rebuilt?


Yes - using augments, cones/sleeves, structural grafts, or specialised implants to re-establish stability and alignment.

Why Choose Agile Ortho?

At Agile Ortho, Durban, the focus is on precision diagnosis, individualised surgical planning, and rehab aligned to your goals. Our surgeons have a special interest in complex hip and knee revision arthroplasty, offering the full spectrum of solutions - from DAIR to advanced reconstructive techniques.

Ready for a Second Opinion or a Plan?

If you’re experiencing ongoing pain, instability, swelling, repeated dislocations, stiffness, or concerns after hip/knee replacement, it may be time to discuss revision options.

Book a consultation at Agile Ortho in Durban today.


We’ll clarify what’s going on and build a recovery plan that makes sense for you.

Educational content only and not a substitute for personalised medical advice. Please consult on of our specialists and the Agile Ortho team for guidance specific to your situation.