Expert Solutions When Hip or Knee Replacement Doesn't Go As Planned
While hip and knee replacement surgery has a high success rate, complications can occur. When joint replacement doesn’t deliver the expected results, specialized expertise is essential. Dr. Ben Deheshi is the surgeon other orthopedic surgeons throughout North Texas trust with their most challenging revision cases. With fellowship training in orthopedic oncology and extensive experience in bone reconstruction (over 3,000 joint replacements including hundreds of revisions), Dr. Deheshi provides expert solutions for patients experiencing complications after joint replacement surgery.
When Joint Replacement Needs Revision
Revision joint replacement surgery becomes necessary when the initial joint replacement fails to function properly or causes ongoing problems. This is not a reflection on the patient or necessarily the previous surgeon—complications can occur even with perfectly performed surgery.
Common Reasons for Revision Surgery:
Persistent Pain
Ongoing pain after joint replacement is the most common reason patients seek revision surgery. Pain may be constant or occur with activity, and often significantly impacts quality of life.
Potential causes include:
- Improper implant positioning
- Infection
- Loosening of components
- Instability
- Component wear
- Nerve impingement
- Soft tissue irritation
Infection
Infection around a joint replacement is a serious complication requiring specialized treatment. Deep joint infections don’t resolve with antibiotics alone and typically require surgical intervention. Dr. Deheshi has extensive experience managing infected joint replacements through:
- Staged revision procedures
- Antibiotic spacers
- Coordination with infectious disease specialists
- Definitive reconstruction after infection is cleared
Instability and Dislocation
Hip or knee instability occurs when the joint doesn’t remain properly positioned. This can cause:
- Joint dislocation requiring emergency care
- Sensation of the joint “giving way”
- Fear of instability limiting activities
- Chronic pain and functional limitations
Causes include improper implant sizing, component malposition, ligament insufficiency, or muscle weakness. Revision surgery addresses the underlying cause and restores stability.
Loosening
Over time, implant components can loosen from the bone. This may occur due to:
- Normal wear over many years Infection
- Inadequate initial fixation
- Bone loss (osteolysis)
- High activity levels
Loosening causes pain, particularly with weight-bearing and activity. X-rays typically show implant migration or bone loss around components.
Stiffness
Severe stiffness after joint replacement prevents normal range of motion. This can result from:
- Scar tissue formation (arthrofibrosis)
- Improper implant sizing or positioning
- Infection
- Prolonged immobilization
- Pre-existing stiffness
When physical therapy and manipulation don’t resolve stiffness, revision surgery may be necessary to restore motion.
Wear and Mechanical Failure
Joint replacement components experience wear over time. Plastic (polyethylene) components can wear out, and metal components can break or fail. Modern implants are designed to last decades, but wear and failure can occur, particularly in younger, more active patients.
Periprosthetic Fracture
Bone fracture around a joint replacement can occur. These cases often require specialized surgical treatment combining fracture management with revision of the joint replacement.
Bone Loss
Significant bone loss can occur around failed joint replacements due to:
- Osteolysis (bone resorption from wear debris)
- Infection
- Stress shielding
- Multiple previous surgeries
Bone loss makes revision surgery significantly more challenging, requiring specialized techniques and often bone grafting.
Why Revision Surgery Requires Specialized Expertise
Revision joint replacement is significantly more challenging than primary joint replacement. Success requires:
Advanced Surgical Skills: Revision surgery involves managing scar tissue, bone loss, and compromised anatomy
Specialized Implants: Revision cases often require custom or specialized components not used in primary surgery
Problem-Solving: Identifying and addressing the cause of failure is essential for successful outcomes
Experience with Complications: Managing infections and severe bone loss requires extensive expertise
Dr. Deheshi’s Unique Qualifications
Dr. Deheshi’s fellowship training in orthopedic oncology provides exceptional expertise in bone reconstruction—skills that translate directly to challenging revision joint replacement cases. This specialized training in managing bone tumors and performing complex bone reconstruction, combined with over 3,000 joint replacements (including hundreds of revisions) performed, makes Dr. Deheshi uniquely qualified to handle:
- Severe bone loss requiring extensive grafting
- Multiple previous failed surgeries
- Infections
- Custom and specialized implant systems
- Combined procedures
Orthopedic surgeons throughout the DFW metroplex refer their most challenging revision cases to Dr. Deheshi because they know he has the training, experience, and expertise to achieve excellent outcomes even in the most difficult situations.
Dr. Deheshi's Approach to Revision Surgery
Comprehensive Evaluation
Every revision case begins with a thorough assessment:
- Detailed review of previous surgical records
- Physical examination focusing on function and pain patterns
- Advanced imaging including X-rays, CT scans, and sometimes MRI
- Laboratory tests to rule out infection
- Joint aspiration when infection is suspected
- Discussion of patient goals and expectations
Personalized Surgical Planning
No two revision cases are identical. Dr. Deheshi develops a customized surgical plan for each patient based on:
- The specific cause of failure
- Amount and location of bone loss
- Presence or absence of infection
- Soft tissue condition
- Patient activity level and goals
- Previous surgical history
Advanced Surgical Techniques
Dr. Deheshi employs state-of-the-art revision techniques including:
- Extensile surgical exposures for optimal visualization
- Bone grafting (morselized or structural) to restore bone stock
- Custom and specialized revision implants
- Advanced fixation methods
- Infection management protocols
Recovery and Rehabilitation
Revision surgery requires extended recovery compared to primary joint replacement. Dr. Deheshi and our team provide:
- Comprehensive post-operative care
- Structured physical therapy programs
- Regular follow-up to monitor healing
- Long-term surveillance for optimal outcomes
Success Rates and Outcomes
While revision surgery is more challenging than primary joint replacement, Dr. Deheshi’s specialized training and experience lead to excellent outcomes:
- High success rates for pain relief
- Restoration of function and mobility
- Long-term implant survivorship
- High patient satisfaction
The key to successful revision surgery is choosing a surgeon with specialized training and extensive experience in bone reconstruction—exactly what Dr. Deheshi’s fellowship training in orthopedic oncology provides.
Your Pain Free Destination for Revision Surgery
Don’t continue suffering after a failed joint replacement. Dr. Deheshi has the specialized expertise to evaluate your situation and provide solutions. Whether you’re experiencing pain, instability, infection, or other complications, we can help.
Second Opinion for Revision Surgery
If you’ve been told “nothing more can be done” or that your revision case is too difficult, get a second opinion from Dr. Deheshi. His fellowship training in orthopedic oncology gives him unique expertise in complex bone reconstruction that other surgeons may not have.