A Second Surgery on an Exactech Joint: What to Ask

Revision surgery replaces some or all parts of a joint implant. A recall alone is not a reason for it. Ask your surgeon what your tests show.

What is revision surgery?

It is a second surgery to fix or replace parts of a joint implant. The surgeon may change one part or all of them. It usually takes longer than the first surgery.

AAOS calls knee and hip revision a longer, more complex surgery than the first one. It needs careful planning and special parts and tools. For Exactech knees, a team at the Hospital for Special Surgery wrote that a planned swap of the plastic liner can turn into a much bigger operation.

Which signs lead doctors to talk about revision?

Worse pain or weakness, trouble bearing weight, swelling that keeps growing, or a loose part can lead to that talk. FDA says the choice is made case by case.

For Exactech knees, the Hospital for Special Surgery team said in 2024 that pain when bearing weight, plus major bone loss on scans, usually points to revision. It said a loose implant should lead to new parts. This is expert opinion, not a study of patients, and several authors reported ties to Exactech.

How is the need for revision diagnosed and treated?

Doctors start with an exam and X-rays. Blood tests check for infection. Scans like CT or MRI can show bone loss around the implant.

For recalled Exactech knees, the same team advised a CRP blood test, a check for infection, for every patient with symptoms. It advised a CT or MRI scan when X-rays look suspicious. It also noted that bone loss found during surgery is often worse than expected.

For people with a recalled Exactech knee, no symptoms and clear X-rays, the team suggested checkups every two to three years. Hip and ankle checkups should be set with your surgeon. FDA does not recommend surgery to remove an Exactech implant that works well.

What does the research say about results?

A second knee replacement usually does not work as well as the first. Some people still have pain or stiffness. Ask your surgeon what to expect for you.

MedlinePlus says a knee implant can be replaced again if it loosens or wears out, but results are usually not as good as the first time. AAOS says revision has a greater risk of problems than the first surgery.

In a Hospital for Special Surgery study of 27 knees with loose parts, Optetrak Logic parts came out after 3.8 years on average. Loose parts from other makers came out after 12 years. The study looked only at failed knees, so it cannot say how often the implant fails.

A study from the Hospital for Special Surgery’s implant-retrieval program looked at 519 Optetrak plastic inserts taken out of patients. It found peeling plastic in 64 of them. The authors linked that damage to the faulty bags.

Can I file a claim if I had a revision?

Possibly, but surgery alone does not decide it. A lawyer looks at the implant, the records and the dates. Do not plan surgery around a claim.

The injury trust’s claim rules ask for proof that you received an Exactech device and for medical records. In 2023 the federal court also adopted a plan for keeping removed implants and tissue samples. If a revision is planned, ask your surgeon how the removed parts will be kept.

What records should I gather?

Keep the notes from both surgeries, the implant labels and your scan results. Ask whether the removed part was saved. Keep a list of dates.

HHS says a provider cannot refuse copies of your records because of an unpaid bill. It may charge the reasonable cost of copying and mailing, but not a fee for searching. Ask for the surgery notes and implant records from each operation.