Most hip and knee replacements perform well for many years – and in many cases, for life. But when a replacement begins to fail, or problems arise that can’t be managed conservatively, revision surgery may be necessary.
Mr Shah has extensive experience in revision surgery and knows that needing further treatment after a previous procedure can feel daunting. While revision surgery is more involved than a primary replacement, patients who are properly assessed and treated by an experienced orthopaedic surgeon can expect excellent outcomes.
What is revision surgery?
Revision surgery involves removing all or part of an existing joint replacement and replacing it with a new implant. It may be needed for a number of reasons, including:
- Loosening of the implant over time, where the bond between the implant and the bone has broken down
- Wear of the bearing surfaces, leading to pain, stiffness or reduced function
- Infection around the joint, which requires careful management and a planned surgical approach
- Dislocation or instability that cannot be resolved without surgical intervention
- Fracture around the implant (periprosthetic fracture)
- Stiffness or poor function that significantly affects quality of life
In some cases, only one component needs to be replaced – a partial revision. In others, the entire implant must be removed and replaced.
Why revision surgery requires more specialist expertise
A primary hip or knee replacement is performed on a joint that, while damaged by arthritis or injury, retains its original anatomy. The surgeon is working with intact bone, predictable landmarks and a clear surgical plan.
Revision surgery presents a different set of challenges – which is why experience matters so much.
The bone needs careful assessment
When an implant loosens or fails, it can cause bone loss around the joint over time. There may be areas that need to be addressed or reinforced before a new implant can be placed securely. Mr Shah plans for this carefully in advance of every revision procedure, using detailed imaging to build a precise picture of the joint before he operates.
The existing implant must be removed
Taking out a well-fixed implant – particularly an uncemented one that has integrated with the bone – requires specialist instruments and a precise, careful technique. Getting this right is crucial to preserving as much healthy bone as possible for the reconstruction.
Infection requires a staged approach
When revision is needed due to infection, a two-stage procedure is often the safest course of action. The existing implant is removed and an antibiotic spacer placed in the joint while a course of treatment is completed, before a new implant is fitted at a second operation. It’s a longer process, but one that gives the best chance of a lasting result.
Reconstruction demands careful planning
Revision implants are designed specifically for these more complex cases. Selecting the right components, planning their positioning and ensuring adequate bone support all require a thorough understanding of revision systems and considerable surgical experience. Mr Shah may also use 3D imaging to help plan your surgery in detail, and occasionally a customised implant may be designed to fit your individual anatomy.
Access to the joint is more involved
Scar tissue from the original surgery means the joint takes more care to reach safely. Mr Shah’s experience with complex cases means he is well prepared for the additional demands this places on the procedure.
Mr Shah’s experience in revision surgery
Mr Shah completed a dedicated arthroplasty and revision fellowship organised by the Furlong Foundation, followed by a fellowship in complex trauma in Hannover, Germany. This specialist training, combined with more than 30 years of orthopaedic practice and over 800 revisions performed, gives Mr Shah extensive experience in complex revision cases.
His procedure volumes for both hip and knee revision surgery are significantly above the national average – you can view his NJR profile here.
He sees patients from across Sussex and beyond – including those seeking a second opinion.
What to expect if you need revision surgery
The process begins with a detailed assessment – reviewing your history, examining the joint and using imaging to build a clear picture before any decisions are made. Mr Shah takes the time to make sure you fully understand your options and feel confident about the path forward.
Recovery from revision surgery is typically longer than from a primary replacement, but most patients make a good recovery with the right surgical approach and aftercare. Mr Shah and his team will be with you every step of the way.
If you’re concerned about a previous joint replacement, or you’ve been told you may need revision surgery, Mr Shah would be happy to help.
