Revision Joint Replacement surgery in Ahmedabad
When an Earlier Replacement Needs Putting Right
A revision means operating again on a replaced knee, hip or shoulder joint that is no longer working well, most often because the implant has loosened, worn, become infected or unstable, or because the bone around it has broken. Some or all of the old parts are removed, the cause is treated, lost bone is rebuilt and new components are fixed in place. Because it is a bigger operation than the first replacement, the reason for failure is confirmed before surgery is advised, with X-rays, blood tests and, where needed, a test of the joint fluid. At PMG Hospital, Gota, Ahmedabad, a knee or hip revision usually means a hospital stay of 5–10 days, and a shoulder revision about 3–5 days.
Implant lifespan
How Long Joint Replacements Usually Last
Most replacements keep working for many years. Two analyses of published case series and national joint registry data, published in The Lancet in 2019, estimated that about 82 in every 100 total knee replacements and about 70 in every 100 partial knee replacements were still in place 25 years after surgery. For total hip replacements, about 9 in 10 lasted 15 years and just over half lasted 25 years. A 2020 analysis of shoulder replacements found that about 9 in 10 total and reverse shoulder replacements had not needed a revision 10 years later.
A smaller number fail sooner, sometimes within the first few years. These are the joints a revision is meant to treat.
Causes
Why a Replacement Stops Working
The cause of failure decides what the operation involves, how long it takes and how the recovery runs.
| Cause | What happens | What it usually means for the revision |
|---|---|---|
| Aseptic loosening | The bond between the implant and the bone gives way without any infection; it often shows as a change between X-rays taken months apart, before it becomes disabling | The loose parts are taken out and new ones are fixed, often with longer stems that reach healthier bone |
| Wear and osteolysis | Tiny particles from the plastic bearing set off a reaction that dissolves bone around the implant, so a joint that felt fine for years can loosen quietly | The worn bearing is exchanged, and lost bone is rebuilt with metal augments, cones or bone graft |
| Infection | Bacteria settle on the implant surface weeks, months or years after surgery | An early infection can sometimes be managed with a thorough washout and new removable parts, keeping the fixed implant; an established one usually needs the implant removed and replaced, either at a single operation or in two stages |
| Instability or dislocation | A hip dislocates more than once, or a knee gives way on stairs, usually because of the position of the parts or the balance of the soft tissues | The position of the parts is corrected, and a more constrained or dual-mobility design may be used |
| Fracture around the implant | A fall breaks the bone close to the implant | If the implant is still firm, the fracture is fixed with plates; if it is loose, the implant is revised to a longer stem that bridges the break |
| Stiffness or a badly placed part | The joint never moved or felt right after the first operation | A revision is considered only if a cause that can be corrected is found, such as a part sitting out of position |
Aseptic loosening and infection are among the most common reasons for revision of knee and hip replacements.
Warning signs
Signs That an Implant Should Be Checked
- Pain that has come back after a period of being comfortable
- A joint that gives way, catches or feels unreliable on stairs
- Swelling or warmth that keeps returning
- A hip that has dislocated more than once
- Wound discharge, fever or long courses of antibiotics after the first operation
- Being able to walk a shorter distance than a year ago
No single sign proves that an implant has failed, but each is a reason to have the joint examined rather than waiting another year.
Assessment
How the Problem Is Worked Out Before Surgery
- 1X-rays compared over time: current standing X-rays are placed beside the oldest available films, because a gradual change around the implant is what reveals loosening or bone loss.
- 2Blood tests: markers of inflammation (ESR and CRP) help show whether infection is likely.
- 3Joint-fluid test: if infection is possible, fluid is drawn from the joint with a needle and sent for culture.
- 4CT scan when needed: it measures how much bone has been lost, so that the rebuilding is planned before the operation.
- 5Planning the implants: the components, any augments or bone graft and the order of the steps are decided in advance.
If the tests show that the implant is sound and the pain comes from another source, such as the spine, a nerve or a nearby tendon, a revision is not advised and that cause is treated instead.
The operation
Revision Joint Replacement Operation: What It Involves
- Removing the old implant while saving as much of the patient’s own bone as possible
- Rebuilding lost bone with metal augments, cones or sleeves, or with bone graft
- Anchoring the new implant with longer stems that reach past weakened bone where needed
- Restoring stability with constrained or dual-mobility bearings when the soft tissues can no longer hold the joint steady
- Treating infection in stages when needed: after the implant comes out, an antibiotic-loaded spacer holds the joint until the infection is controlled, and the new implant goes in at a second operation
After surgery, physiotherapy is built up in stages, and weight on the limb may be limited for as long as the rebuilt bone needs to heal.
By joint
Knee, Hip and Shoulder Revision Compared
| Joint | Common reasons | Hospital stay at PMG Hospital | Usual recovery |
|---|---|---|---|
| Knee | Loosening, plastic wear, infection, instability, stiffness or a misplaced part, or a break in the bone next to the implant | 5–10 days | Weight on the leg limited for a few weeks; structured rehabilitation over three to six months |
| Hip | Loosening of the stem or cup, repeated dislocation, wear with bone loss, infection, fracture of the thigh bone around the stem | 5–10 days | Weight on the leg commonly limited for four to six weeks; recovery over four to six months, depending on the bone rebuilt |
| Shoulder | A loose or worn earlier replacement, failure of the rotator cuff after an earlier replacement, repeated instability | About 3–5 days | Sling for about four weeks; useful overhead movement usually returns between three and six months |
Joint-specific pages: Revision knee replacement·Revision hip replacement·Revision and reverse shoulder replacement
Expectations
Realistic Expectations After a Revision
What Often Improves
- Pain usually settles once the cause has been dealt with
- The joint usually becomes stable and dependable for daily walking, stairs or arm use
What Is Usually Different From a First Replacement
- The range of movement is, on average, a little less
- Recovery takes longer
- The new implant is generally not expected to last as many years
- These differences tend to be greater when much bone has been lost or an infection had to be cleared first
Risks
Risks of Revision Surgery
A revision carries more risk than a first joint replacement. The risks to discuss before surgery include:
- Infection, which is more likely than after a first replacement
- Greater blood loss, sometimes needing a transfusion
- A clot in a leg vein (DVT), which can travel to the lungs
- Injury to a nerve or blood vessel
- A crack or break in the bone while the old parts are removed, or later
- The new joint slipping out of place or feeling loose
- Loosening of the new implant over time
- Strain on the heart and lungs from a longer anaesthetic, especially in older patients
- Pain or stiffness that continues despite the operation
- The possibility of needing further surgery
These risks are worth weighing when the joint has truly failed; they are not worth taking for pain that has another cause.
First visit
Records to Bring for a Revision Assessment
- The operation notes and implant details from the first surgery, if available
- Every X-ray taken since that operation, arranged from the oldest to the newest
- Any record of fever, wound discharge or long courses of antibiotics
- A list of current medicines and other medical conditions
- The name of the hospital and surgeon who did the first operation, so that records can be requested if needed
Cost
Revision Joint Replacement Cost in Ahmedabad
- Which joint is being revised, and whether one or more parts are replaced
- Whether a single operation is enough or an infection calls for a two-stage revision
- The implants used, including any augments, cones or bone graft
- The room category and the number of days in hospital
- Scans and tests before surgery, physiotherapy and follow-up visits
A revision generally costs more than a first joint replacement. PMG Hospital gives a written, itemised estimate after the assessment. Check your cover with your insurance provider.
The care team
Revision Joint Replacement Doctor in Ahmedabad
A revision joint replacement doctor in Ahmedabad is an orthopaedic surgeon with training in arthroplasty (joint replacement) who also undertakes repeat operations on knee, hip or shoulder implants. Because finding the cause of failure is half the work, the surgeon relies on several colleagues at different points:
| Stage | Who is involved | What they do |
|---|---|---|
| Finding the cause | Orthopaedic surgeon | Examines the joint, lines up old and new X-rays, and decides whether the implant has failed or the pain has another source |
| Imaging | Radiologist | Reads the X-rays and the CT scan that maps bone loss, and may guide a needle into the joint with ultrasound or X-ray to draw fluid |
| Infection testing | Microbiologist or infectious disease physician | Grows organisms from joint fluid and tissue samples, then advises which antibiotics to use and for how long, including between the stages of a two-stage revision |
| Medical preparation | Physician or cardiologist | Prepares the heart, lungs, kidneys, sugar levels and blood-thinning medicines for a longer operation, and corrects a low haemoglobin beforehand |
| Anaesthesia | Anaesthetist | Chooses between spinal and general anaesthesia, with or without a nerve block, according to the joint and the expected length of surgery, and plans pain relief afterwards |
| Rehabilitation | Physiotherapist | Builds up exercise in stages while respecting any limits on weight-bearing or arm use set by the surgeon |
Questions
Revision Joint Replacement Surgery Doctor in Ahmedabad: Questions to Ask
Apart from fractures and some acute infections, most revisions are planned operations, which leaves time to go through the details calmly. Before you sign the consent form, these are useful points to raise with any revision joint replacement surgery doctor in Ahmedabad:
- What exactly has caused my implant to fail, and how certain is that conclusion?
- Will all the parts be changed, or only the loose or worn ones?
- Has bone been lost, and will it be rebuilt with metal augments, cones or bone graft?
- Is a longer stem or a more constrained implant planned, and for what reason?
- How likely is a blood transfusion, and should my haemoglobin be raised before surgery?
- Should any of my regular medicines, for example blood-thinning or sugar-lowering ones, be paused or adjusted beforehand?
- Given my age and other health problems, which risks apply most to me?
- After recovery, at what intervals should the revised joint be examined and X-rayed?
Surgeon
Who Performs the Operation
At PMG Hospital, Gota, revision of knee, hip and shoulder replacements is performed by:
| Field | Detail |
|---|---|
| Surgeon | Dr. Hiren Patel |
| Qualifications | MBBS, MS (Ortho), International Fellowship in Joint Replacement |
| Medical college | B.J. Medical College, Ahmedabad (MBBS and MS (Ortho)) |
| Role at PMG Hospital | Director & Head Joint Replacement Surgeon |
| Registration | Registered Medical Practitioner; Gujarat Medical Council Reg. No. G-20583 |
| OPD | Monday to Saturday, 10:00 AM to 8:00 PM; Sunday by appointment |
Hospital
Where the Operation Takes Place
Revision joint replacement is carried out at PMG Hospital, Gota, Ahmedabad. Services relevant to revision joint replacement include:
- Orthopaedic OPD: Monday to Saturday, 10:00 AM to 8:00 PM; Sunday by appointment
- Emergency and trauma care, available 24×7
- Physiotherapy at the hospital
Contact
Reaching PMG Hospital
Address
PMG Hospital (PMG Orthopedic Hospital)
3rd Floor, Athena Avenue, B/H Jaguar Showroom, Krishna Hardware Road, Nr. Eulogia Inn Hotel, S.G. Highway, Gota, Ahmedabad, Gujarat 382481
- Phone
- +91 96625 91666
- Phone and WhatsApp
- +91 96627 70141
- OPD
- Monday to Saturday, 10:00 AM to 8:00 PM; Sunday by appointment
- Emergency and trauma care
- 24×7
Get in touch
Call or send your reports, or open the hospital’s location in Google Maps.
Medically reviewed by Dr. Hiren Patel, MS (Ortho.), Joint Replacement Surgeon, PMG Hospital, Ahmedabad.