Revision joint replacement
Revision is the operation for a hip or knee replacement that has worn, loosened, become infected, or stopped working as it should. Dr Jason Tsung is fellowship-trained in both primary and revision joint replacement, and manages complex revision of the hip and knee.
Written and reviewed by Dr Jason Tsung, FRACS (Orth) · Last reviewed June 2026
Most hip and knee replacements last. Australian registry data show that around 95% are still working at ten years,¹ and only a small proportion are revised within that time.³ Revision is the operation for that minority, repairing or replacing a previous joint replacement that has worn, loosened, become infected, or stopped working as it should.
What is revision joint replacement?
Revision joint replacement replaces some or all of an existing artificial joint. It can be straightforward, swapping a single worn part such as a plastic liner, or it can be a larger reconstruction that removes the old implant, rebuilds lost bone, and fits a new one. It is a different operation from your first replacement: more complex, usually longer, and planned around what has gone wrong and what bone and soft tissue remain.
Why might a joint replacement need revising?
A replacement can fail for several reasons, and the cause matters because it shapes the operation.²
- Loosening and wear. Over years, the bond between implant and bone can loosen, or the bearing surface can wear. This is the most common reason hip replacements are revised, and a frequent reason for knees.
- Infection. Bacteria can settle on an implant, sometimes years after surgery. Infection is now among the most common reasons joint replacements are revised, and in Australia it is the leading reason for knee revision.² It often needs a different approach from other revisions, sometimes in two stages.
- Instability or dislocation. A hip that repeatedly dislocates, or a knee that feels unstable, may need its components repositioned or replaced.
- Fracture around the implant. A break in the bone next to a replacement, usually after a fall, can loosen or damage the joint and often needs surgery.
- Stiffness or ongoing pain. Less often, a replacement that stays stiff or painful without another clear cause is assessed for revision, once other explanations are ruled out.
Signs worth getting checked
A replacement that has served you well for years doesn't usually fail overnight, and new symptoms don't always mean something is wrong. But some are worth having assessed rather than waiting:
- new or increasing pain in a joint that was comfortable
- a change in how the joint feels: looseness, clicking, giving way, or a grinding sensation
- swelling, warmth, or redness, particularly with fever, which can point to infection
- difficulty bearing weight, or a change in how you walk
- pain that starts after a fall or injury
If you notice these, see your GP. An early assessment is usually straightforward, and finding a problem early generally gives more options than leaving it.
How a revision problem is assessed
Getting the diagnosis right is the most important step, because the right operation depends on it. Assessment usually involves a consultation and examination, X-rays, and often blood tests. Where infection is a possibility, fluid may be drawn from the joint and tested, and further scans may be arranged. The aim is to know exactly what has happened, and why, before any decision about surgery.
What revision surgery involves
Revision is tailored to the problem. A worn liner might be exchanged on its own. A loose implant is removed and replaced, and any lost bone is rebuilt, sometimes with bone graft or specialised implants designed for revision. Infection is often managed in two stages: the implant is removed and the infection treated first, with a new joint fitted at a later operation once it has cleared. Because revision works around an existing implant and altered anatomy, it typically takes longer than a first-time replacement and the hospital stay can be longer.
Recovery
The principles are the same as a first joint replacement: early movement, physiotherapy, and a gradual return to activity. The pace is often slower and more variable than after primary surgery, because revision asks more of the bone and soft tissue, and because the starting point differs from person to person. Dr Tsung will give you a realistic picture of recovery for your specific operation.
Results and risks
For many people, revision relieves pain and restores a joint that had stopped working. The result is less predictable than a first-time replacement: outcomes vary more, recovery can be slower, and the risk of complications, among them infection, dislocation, fracture, blood clots, and the chance of further surgery, is higher than for primary joint replacement.² How likely a good result is in your case, and what the specific risks are, depends on the cause, the state of the bone, and your general health, and Dr Tsung will go through this with you before any decision. Individual results vary.
Dr Tsung's approach
Dr Tsung is fellowship-trained in both primary and revision joint replacement, and manages complex revision of the hip and knee. That covers the full range, from exchanging a single worn component, through major reconstruction where bone has been lost, to two-stage treatment of an infected replacement. Revision hip surgery can, where suitable, be carried out through the direct superior approach he uses for many primary hip replacements. Every revision starts with an accurate diagnosis and a clear explanation of the options, because the right operation depends on knowing exactly what has gone wrong.
If you are still weighing up a first-time replacement, see hip replacement, knee replacement, and robotic-assisted joint replacement. For how long a modern replacement is expected to last, see how long does a knee replacement last.
Common questions
How do I know if my joint replacement is failing?
New or increasing pain, a change in how the joint feels, swelling or warmth, or trouble bearing weight are all worth having checked by your GP. Many turn out to be minor, but an early assessment gives the most options.
Is revision surgery more difficult than the first replacement?
Usually, yes. It works around an existing implant and altered bone, often takes longer, and recovery can be slower. The result is also less predictable, though many people get good relief.
How long does a revision last?
It depends on the reason for the revision and the type of operation. Your surgeon can give you a realistic expectation once the cause is clear.
Can a robot be used for revision surgery?
Robotic planning is used mainly for first-time joint replacement. Revision is planned around the existing implant and bone, and the approach is tailored to the individual problem.
Book or refer
To see Dr Tsung you’ll need a referral from your GP or another specialist. Call reception on (07) 5676 9930 to book your first appointment, or email hello@sgco.au. New patients can pre-register online before the visit; the form prepares your records and does not book an appointment. For costs, see fees and health funds.
References
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2025 Annual Report. Adelaide: AOA; 2025.
- Hauer G, et al. Septic complications are on the rise and aseptic loosening has decreased in total joint arthroplasty: an updated complication-based analysis using worldwide arthroplasty registers. Archives of Orthopaedic and Trauma Surgery. 2024;144(12):5199–5204.
- Gademan MGJ, et al. Population-based 10-year cumulative revision risks after hip and knee arthroplasty for osteoarthritis. Acta Orthopaedica. 2021;92(3):280–284.