Symptoms of Hip or Knee Replacement Failure

For hip or knee replacement failures, you may experience the following symptoms:

• loosening or instability,
• infection,
• frequent or recurring hip dislocations,
• fracture, or
• a metal allergy.

Loosening or Instability

During your initial knee or hip replacement surgery, the prosthetic (artificial) components were either cemented (attached with bone cement) or hammered into the bone so they could eventually attach to your bone. If your bone fails to grow onto the components or the cement loosens over time, your joint will feel painful, unstable, or loose.

The following things may increase the chances of your hip or knee joint loosening:

• excess body weight (obesity) that puts strain on the joint components,
• high-impact activities or exercises, or
• wear and tear of components over time.

Most initial hip or knee replacement parts are designed to last 15 to 20 years. If you get a replacement surgery at a younger age, you may be more likely to need a revision surgery later as the components naturally wear out over time.

The most common symptoms associated with loosening or instability in the hip or knee joint include:

• pain,
• popping or clicking sound,
• sensation that your joint is moving in and out of its socket,
• partial hip dislocation (sublaxation),
• full hip dislocation,
• sensation of your knee “giving out” when you put weight on it, or
• swelling in and around your replacement knee joint.

Infection

One of the most serious complications that could require a revision hip or knee  replacement, is infection from bacteria that grow in and around the surface of prosthetic (artificial) parts. Some people may experience infection shortly after the initial joint replacement surgery, but it can also occur several years later. Once bacteria starts to grow on and around the replacement components, it can be very difficult to remove without surgery to remove the components, cement and dead bone.

Symptoms of an infection in a knee or hip replacement joint include:

• pain,
• redness,
• swelling,
• instability,
• drainage, or
• wounds that do not heal.

Serious infections may require treatment in an emergency room. Seek care immediately if you are also experiencing: 

• fever,
• severe muscle aches,
• nausea or vomiting,
• diarrhea, or
• severe fatigue.

Most infections will require revision surgery. Your orthopedic surgeon will help determine what type of procedure is best based on: 

• type of bacterial infection,
• severity of the infection, and
• how long you have been experiencing the infection.

Our surgeons work closely with musculoskeletal infectious disease experts at the University of Utah Hospital to identify risks and prescribe treatment for patients who need a revision surgery as a result of chronic infections. This unique coordinated care model between orthopedic surgeons and infectious disease experts will save you time and prevent the need for multiple labs or other redundant care.

Frequent or Recurring Hip Dislocations

Your hip joints are made of a stem, ball and socket. Hip dislocations occur when the ball of the joint (attached to a stem in your thigh bone) comes out of the socket (attached to your pelvic bone). Some hip dislocations are the result of trauma, such as an accident, but if you frequently have hip dislocations after a hip replacement surgery, you may need a revision to correct the position and size of your hip components.

Symptoms of a hip joint dislocation include:

• severe pain in and around the hip or groin area,
• inability to walk,
• weakness or inability to move your leg, and
• one leg that is noticeably shorter than the other.

Fracture

After a hip or knee replacement surgery the prosthetic joint will be connected to your surrounding bones. A fracture in one of these bones may cause your new joint to loosen or get damaged. Fractures may be the result of a fall or other trauma, such as a direct hit to your hip or knee. 

Metal Allergy or Reaction

If your initial hip replacement was prior to May 2016, your surgeon may have implanted a metal-on-metal device (both the ball and socket components are metal). As these two pieces rub together during everyday activities, they can release microscopic metal particles into your body. This may lead to sensitivity or an allergic reaction in some patients. There are no FDA-approved metal-on-metal hip replacement components available today, but you may need a revision hip surgery if you had one done prior to 2016 and are experiencing symptoms of a problem.

Even if you did not get a metal-on-metal joint, you may still experience sensitivity to metal components that are used in hip and knee replacement joints. It is difficult to diagnose a metal allergy or reaction. However, talk to your orthopedic surgeon if you experience: 

• large area of swelling,
• joint pain,
• joint stiffness,
• skin discoloration,
• a skin rash near the joint, or
• itching around the artificial joint.