Most replacements last — but not all
Modern hip and knee replacements are among the most successful operations in medicine, with the large majority functioning well beyond 15–20 years. A minority develop problems needing revision: mechanical loosening, plastic (polyethylene) wear, instability, fracture around the implant, or infection. Early evaluation consistently makes treatment simpler — bone lost to a loose implant, for instance, is easier to reconstruct sooner than later.
Warning signs worth evaluating
New or worsening pain in a joint that had been comfortable — especially start-up pain when rising, or thigh/groin pain with a hip. A sense of instability, buckling, or dislocation. New swelling, warmth, or redness. Audible squeaking, clicking, or grinding that's new. A leg that feels newly shorter, or a limp that returns. Fevers or drainage near the joint — a potential infection sign needing prompt attention.
None of these prove implant failure — but all deserve an X-ray and examination rather than watchful waiting on the internet. Persistent unexplained pain after replacement always merits a workup.
What a revision evaluation involves
Revision assessment is detective work: comparison of current X-rays with prior ones, blood tests to screen for infection, sometimes joint aspiration or advanced imaging, and review of your original operative records — including the implant's make and model. Dr. Vojdani, fellowship-trained in adult reconstruction at Columbia, evaluates and performs complex revision surgery, and coordinates with infectious disease specialists when infection is involved.
If you're unsure whether your symptoms warrant concern, a second opinion on a painful replacement is always reasonable — bring your operative report and prior X-rays if available.
Common Questions
How do I know if my knee replacement is loose?
Classic signs are pain when starting to walk that eases with movement, deep aching with weight-bearing, and changes on serial X-rays. Only imaging and examination can confirm loosening.
Can an infected joint replacement be saved?
Sometimes — early infections may respond to surgical washout with component retention, while established infections typically require staged revision surgery. Speed of diagnosis matters enormously, which is why new warmth, swelling, or drainage deserves urgent evaluation.
This guide provides general educational information and is not a substitute for individualized medical advice. Treatment decisions should always be made in consultation with your surgeon based on your specific anatomy, imaging, and health history.