Problems with a joint replacement

Overview

Infection after a joint replacement needs fast treatment to save the implant.

Loosening and wear can happen after many years.

Symptoms

Common signs:

• Pain or swelling in a replaced joint

Less common

• Fever
• Clicking

When to get medical care

Causes

Wear, infection.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• People with diabetes or obesity: Higher risk of infection
• Active people: Parts wear faster

Possible complications

• Bone infection (osteomyelitis): Joint infection

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

• X-ray:
• Blood tests:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

• Keep follow-ups
• Do physical therapy

Prevention

To lower your risk or prevent problems:

• Tell dentists about your joint

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to an orthopedist (bone and joint doctor).
• A physical therapist can help with exercises to rebuild strength and motion.

Living with it

• Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
• Bring a list of your medicines and questions to each visit.
• Stay active with low-impact exercise like walking, swimming, or biking.
• Use heat for stiffness and ice for flare-ups.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• People with diabetes: Higher infection risk.
• Older adults: Most common.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Most problems can be fixed.

Most are fixed with surgery.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What's causing this?
• What treatment do you recommend?
• Do I need a revision surgery?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Problems with a joint replacement