First determine why the existing prosthesis is failing
UKE specifically separates problems with existing hip and knee implants from primary joint replacement and lists loosening, infection, instability, dislocation, wear and unexplained pain among revision-related problems. A revision operation should therefore follow a cause-focused work-up rather than the assumption that every painful prosthesis needs exchange.
Infection must be considered before revision planning
A suspected prosthetic-joint infection can change the entire treatment sequence. The specialist team may need laboratory testing, imaging and joint-specific diagnostic procedures before deciding whether revision is appropriate and how it should be staged. International patients should send previous microbiology, antibiotic history and operative reports when available.
Implant records matter more than in primary replacement
Revision planning depends on the current components, fixation method, prior surgical approach and available bone. Bring or send the implant card, manufacturer information, previous operation reports and older X-rays when possible so the center can understand how the joint changed over time.
- Implant card and manufacturer/model information
- Original and revision operative reports
- Earlier and current X-rays for comparison
- CT or other imaging when already performed for a defined reason
- Microbiology and antibiotic history if infection has been suspected
- Previous wound or drainage problems
Bone loss and reconstruction can make revision surgery more complex
Charité describes revision hip arthroplasty with reconstruction of bone defects using advanced implant systems, including custom or tumor-type prostheses in selected complex situations. The extent of bone loss and soft-tissue damage can affect the operation, implant strategy, blood loss, inpatient care and rehabilitation.
Pain after replacement is not always solved by changing the implant
UKE also evaluates complications such as unexplained pain, instability, dislocation and impingement. The orthopedic team should determine whether symptoms are actually caused by the prosthesis and whether revision is expected to improve function or pain before exposing the patient to another major operation.
Hip and knee revision are related but not identical pathways
The principles of diagnosis overlap, but anatomy, implant design, ligament balance, bone defects and reconstructive options differ between hip and knee revision. Ask for a joint-specific explanation of what will be removed, retained or reconstructed and what functional result is realistic.
International travel requires a longer recovery plan
Revision surgery can require more complex inpatient care and rehabilitation than uncomplicated primary arthroplasty. Before travel, clarify expected hospital stay, weight-bearing restrictions, walking aids, wound checks, thrombosis prevention, physiotherapy, possible antibiotic treatment and when long-distance travel home is medically reasonable.
Records to prepare for specialist review
A useful remote review should include the history of the original replacement and the evidence explaining the current problem.
- Current hip or knee X-rays and reports
- Older imaging for comparison when available
- Implant card and prosthesis details
- All previous joint-operation reports
- Laboratory, aspiration or microbiology results if infection was investigated
- Current pain, instability and walking limitations
- Medication list, including antibiotics and anticoagulants
- Major medical conditions and prior complications
Official sources
Sources last checked 2026-08-31. Surgical indications, hospital pathways and rehabilitation plans can change; confirm the current plan with the treating orthopedic or spine team.
- Orthopedic treatment spectrum – primary and revision arthroplasty — University Medical Center Hamburg-Eppendorf (UKE) ↗
- Hip and knee arthroplasty clinic – prosthesis exchange and infected implants — University Medical Center Hamburg-Eppendorf (UKE) ↗
- Hip and pelvis surgery – painful prostheses and revision hip replacement — Charité – Universitätsmedizin Berlin ↗