Revisions

Aseptic loosening remains the commonest cause: microscopic wear particles provoke a biological reaction that resorbs the bone around the implant. Next come periprosthetic infection, which is the most serious and demands an entirely different strategy, instability with recurrent dislocation, periprosthetic fracture after a fall and, less often, implant breakage.

Pain that returns after a period during which the joint worked well. Pain on the first few steps. A sense that the leg is giving way. A change in leg length. Swelling, redness, a discharging wound or fever. Any of these needs prompt assessment with radiographs, inflammatory markers and, where infection is suspected, aspiration of the joint.

The longer revision is delayed, the more bone is lost and the more complex the reconstruction becomes. Loosening identified early is managed with simpler implants and a better functional result. That is why every joint replacement, even a symptom-free one, deserves regular radiographic follow-up.