Revision Knee & Hip Surgery

While joint replacement surgery offers life-changing pain relief and improved mobility for most patients, some individuals may experience complications or unsatisfactory outcomes following their initial procedure.

Revision surgery is a specialised area of orthopaedics that involves correcting or replacing a previously implanted hip or knee joint. These procedures are often more complex than the original surgery and require a high level of surgical expertise and experience.

Dr Anthony Keeley is a Sydney-based orthopaedic surgeon with over 15 years of experience in both primary and revision joint replacement surgery, with a particular focus on the knee and hip. He regularly treats patients who have undergone surgery elsewhere and are now seeking a second opinion due to pain, poor function, instability, or implant failure.

With advanced training and years of experience in major reconstructive techniques, modern implant technologies, and a commitment to restoring comfort and confidence, Dr Keeley provides tailored revision surgery for patients who have not achieved the results they deserve.

Reasons for Revision Joint Surgery

Revision hip and knee surgery may be necessary when the initial joint replacement fails to function as intended. Some common reasons for revision surgery include:

  • Implant loosening or wear
  • Infection in the joint
  • Instability or dislocation
  • Fractures around the implant
  • Misalignment or poor positioning
  • Persistent pain or stiffness
  • Implant breakage
  • Allergic reaction or metal sensitivity

Dr Keeley conducts thorough investigations, including highly specialised imaging and blood tests, to determine the cause of the issue and develop a personalised surgical plan.

Revision Knee Replacement

Revision knee replacement is performed when the original knee prosthesis has failed or produced unsatisfactory results. It may involve replacing one or more components of the knee implant and addressing surrounding bone or soft tissue problems.

Common Indications for Revision Knee Surgery

Over-time, prosthetic components can loosen from the bone, or the surface can wear out, leading to pain and instability.

  • Symptoms: Deep aching pain, instability, reduced function, swelling
  • Causes: Natural wear over time, excessive activity, implant positioning issues
  • Risks: Bone loss, chronic pain, impaired mobility
  • Investigations: X-rays, bone scan / CT (SPECT scan), white cell scan, blood tests
  • Treatment Options:
    • Full or partial revision knee replacement with updated prosthetic components
    • Bone grafting if bone loss has occurred, soft tissue management

Some patients experience a knee that feels unstable, out of alignment or wobbly after primary surgery.

  • Symptoms: Knee giving way, pain during movement, difficulty walking
  • Causes: Incorrect ligament balance, poor alignment, soft tissue issues
  • Risks: Recurrent falls, reduced confidence, ligament failure, early implant failure
  • Investigations: X-rays, alignment CT scan
  • Treatment Options:
    • Revision surgery to correct alignment with new implants
    • Revision surgery to correct instability using more stable “constrained” implants
    • Soft tissue reconstruction if needed

Periprosthetic joint infection is a serious complication that may arise shortly after surgery or even years later.

  • Symptoms: Persistent severe pain, swelling, redness, heat, fever, fluid leakage
  • Causes: Bacterial contamination during or after surgery
  • Risks: Joint destruction, systemic infection, implant loosening, chronic pain, poor function
  • Investigations: X-rays, bone scan / CT (SPECT scan), white cell scan, blood tests, joint aspiration
  • Treatment Options:
    • Debridement / washout and implant retention (DAIR) in some cases
    • One- or two-stage revision surgery with implant removal and antibiotic treatment
    • Collaboration with infectious disease specialists for tailored care

Revision Hip Replacement

Revision hip surgery involves removing and replacing part, or all of a previously inserted hip prosthesis. These procedures are often more technically demanding due to scar tissue, bone loss, the need for implant removal, and the use of specialised, complex implants.

Common Indications for Revision Hip Surgery

Recurrent dislocation is one of the most distressing complications after hip replacement.

  • Symptoms: Hip “popping out,” pain, apprehension with movement
  • Causes: Poor soft tissue tension, implant orientation issues
  • Risks: Falls, loss of confidence, tissue damage, implant damage
  • Investigations: X-rays, CT
  • Treatment Options:
    • Revision using modern implants that improve joint stability

Periprosthetic joint infection is a serious complication that may arise shortly after surgery or even years later.

  • Symptoms: Persistent severe pain, swelling, redness, fever
  • Causes: Bacterial contamination during or after surgery
  • Risks: Joint destruction, systemic infection, implant loosening, chronic pain, poor function
  • Investigations: X-rays, bone scan / CT (SPECT scan), white cell scan, blood tests, joint aspiration
  • Treatment Options:
    • Debridement / washout and implant retention (DAIR) in some cases
    • One-or-two-stage revision surgery with implant removal and antibiotic treatment
    • Collaboration with infectious disease specialists for tailored care

In some cases, implant components wear out or lead to a reaction in surrounding bone or muscle, causing structural weakening or muscle damage.

  • Symptoms: Increasing pain, reduced mobility, grinding or instability
  • Causes: Polyethylene or metal wear, immune response to debris, aging implants
  • Risks: Bone loss, fracture, implant loosening, irreversible muscle damage
  • Investigations: X-rays, CT, MRI, SPECT scan, blood tests
  • Treatment Options:
    • Removal of failing implant
    • Bone grafting, specialised or custom-made implants to rebuild joint architecture
    • New prosthesis inserted using precise alignment techniques

A small subset of patients experience ongoing pain following joint replacement, even when imaging appears normal.

  • Symptoms: Chronic pain, stiffness, functional decline
  • Causes: Implant malposition, overlooked soft tissue issues, hypersensitivity
  • Risks: Reduced quality of life, mental health strain
  • Investigations: X-rays, CT, MRI, SPECT scan, white cell scan, blood tests, allergy testing
  • Treatment Options:
    • Exploratory revision surgery only after ruling out non-surgical causes
    • Implant revision or realignment if required

A Highly Specialised Procedure Requiring Expert Care

Revision surgery is inherently more complex than first-time joint replacement.

It often involves:

  • Managing soft tissue complications
  • Addressing significant bone loss or deformity
  • Eradicating / treating infection, when necessary
  • Rebuilding joint alignment and achieving stability using modern, complex implants
  • Reducing the risk of future dislocation, infection or mechanical failure

Dr Anthony Keeley brings over 15 years of surgical experience, specialised training, and a track record of helping patients recover mobility and quality of life after failed joint procedures. With access to advanced imaging, modern implants / techniques, personalised custom-made implant systems, and a collaborative care team approach, he provides clear, compassionate guidance through what can be a difficult journey.

If you’ve had a hip or knee replacement and are still experiencing pain, poor function, or dissatisfaction with your outcome, revision surgery may offer a path forward with the right surgeon by your side.

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Dedicated to Clinical Excellence & Patient Care

Dr Anthony Keeley draws on years of experience and a deep understanding of knee and hip biomechanics to tailor each procedure to the patient’s anatomy, goals and lifestyle.

If your prior knee or hip replacement has failed due to issues like wear, loosening, infection, or instability, Dr Keeley offers significant expertise in this challenging area of orthopaedic surgery with a personal, compassionate approach to care.

Learn more about Dr Anthony Keeley