Joint replacement surgery is a routine procedure to treat severe joint pain caused by arthritis or serious injury. It is a highly successful approach with excellent patient satisfaction ratings.
However, prosthetic implants eventually wear out and need to be replaced. Or, the implant may loosen, dislocate or become infected, all of which means the original implant needs replacing. This procedure is called revision joint replacement and, unfortunately, it generally has lower satisfaction levels and a higher risk of complications compared to primary joint replacement surgery.
In this article, we’ll look at some recent statistics on revision joint replacements to help us understand more about the procedure and its outcomes.
A study by Bristol Medical School
In 2022, The Lancet published a study by the Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School and Southmead Hospital Bristol. It explored how long revision hip replacements last and what happens when re-revisions are needed. The team wanted to provide detailed information on the longevity of hip replacement surgery.
The article explained that there are more than 100,000 primary total hip replacements each year in England and Wales and that a 2019 meta-analysis found that 57.9% of total hip replacements last more than 25 years. However, according to the National Joint Registry in England and Wales, on average in 2021, 4.3% of primary hip replacements need revision surgery within 10 years. It was a similar figure for primary knee replacements (with 4.1% requiring revision within 10 years).
The research team from Bristol looked at data on hip replacements from the National Joint Registry. It focused on osteoarthritis as the sole reason for undergoing the primary hip replacement and determined the likelihood of revision and subsequent re-revision using Kaplan-Meier estimates [this is a way of estimating survival function using non-parametric statistics].
They found that between April 1 2003 and December 31 2019, there were 29,010 revision hip replacements with a linked primary episode. As might be expected, revision rates were higher in patients below the age of 55. After having revision hip replacement surgery, 21.3% required further revision surgery within 15 years, 22.3% of second revisions were revised again within seven years and 22.3% of third revisions were revised again within three years
Hip resurfacing
Sometimes, patients are offered hip resurfacing rather than a total hip replacement. While the latter involves replacing both the femoral head and the hip socket, in hip resurfacing the femoral head is trimmed and capped with a smooth metal covering rather than being removed, and damaged bone and cartilage in the socket are removed and replaced with a metal shell.
The Bristol research study also looked at patients who underwent revisions of hip resurfacing procedures. The numbers were similar to those relating to hip replacements – 23.7% of hip surfacing revisions were revised again within 15 years, 21.0% of second revisions were revised again within seven years and 19.3% of third revisions were revised again within three years.
Diminishing success rates for each subsequent re-revision
The Bristol study concluded that younger patients have a greater chance of needing multiple hip joint revisions compared to older patients. This is unsurprising as many older patients reach the end of life before their implant requires replacement.
The likelihood of needing further revision surgery increases with each procedure a patient has and each subsequent revision lasts for roughly half the time of the previous ones. So, while a total hip replacement is generally an effective procedure for improving pain and function, and can last many years, if the primary surgery needs to be repeated, each successive revision is less and less successful.
Avoiding revision joint replacement wherever possible
While revision joint replacement surgery is sometimes unavoidable, and necessary if the implant has failed, as orthopaedic surgeons we do whatever we can to ensure that patients don’t need it. One of the ways we do this is by preserving as much healthy bone and tissue during the primary joint replacement as we can which can help improve the outcomes of revision joint replacement surgery.
Carrothers Orthopaedics was one of the pioneers of Mako robotic arm assisted surgery, which from the literature, appears to consistently deliver better outcomes than conventional joint replacements – including lowering the risks associated with revision surgery.
Take a look at this article which explains more in relation to knee surgery.
If you require a revision joint replacement and would like to discuss your options, or if you are undergoing primary joint replacement surgery and want to reduce your risk of needing revision surgery in the future, contact us for specialist advice and support.
We provide both conventional joint replacement surgery and state-of-the-art Mako joint replacements and are happy to advise on all aspects of primary and revision joint replacement surgery.
Related Reading on Mako Robotic Joint Replacements
We have plenty of resources on our website about Mako Joint Replacements. Here are some useful articles:
Treating Arthritis with a Mako Partial Knee Replacement
Treating Arthritis with a Mako Total Knee Replacement
Treating Arthritis with a Mako Total Hip Replacement
Mako Robotic Arm-Assisted Joint Replacements: Going from Strength-to-Strength
Who is Opting for Mako Robotic Arm-Assisted Joint Replacement Surgery?
Where to Find Out More About Mako Joint Replacement Surgery
Am I Suitable for Mako Robotic Arm Assisted Joint Replacement Surgery?
How Long Will my Mako Knee Replacement Last?
Mako Robotic Arm-Assisted Joint Replacement Explained
Talk to an orthopaedic consultant | Cambridge
We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako robotic arm assisted surgery and conventional surgery.
For more information, please contact us.
Our consultation fees are clearly presented here.
For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.
