A person facing a choice in their joint health journey.

Joint Replacement Reality Check: Are You Prepared for Round Two?

Mira Elwood in Health & Wellness August 2025 • 4 min read.

"Understand the risk factors and likelihood of needing a second joint replacement after your initial surgery."

Undergoing joint replacement surgery can dramatically improve quality of life, relieving chronic pain and restoring mobility. However, for many, it's important to understand that this might not be the end of the road. While the initial surgery aims for long-term relief, a significant number of individuals will eventually require a subsequent joint replacement, either in the same joint or a different one.

A recent study published in The Journal of Bone and Joint Surgery sheds light on this reality, revealing the prevalence and risk factors associated with needing a second joint replacement. The study looked at data from over 85,000 patients who underwent initial shoulder, hip, or knee arthroplasty, tracking their outcomes over 5 to 8 years.

Whether you're considering joint replacement surgery or have already undergone the procedure, understanding the potential for future interventions is crucial for informed decision-making and managing expectations. This article breaks down the key findings of the study, offering insights into who is most at risk and what factors you can control to improve your long-term joint health.

Second Surgery: What's the Real Risk?

A person facing a choice in their joint health journey.

The study's findings highlight that subsequent joint replacement is more common than many might realize. Over the 5-to-8-year follow-up period, nearly a quarter (23.6%) of patients required a replacement of the contralateral joint (the joint on the opposite side of the body). Additionally, a smaller but still notable percentage (3.7%) needed a replacement in a completely different joint.

Several factors were identified as significant predictors of needing a subsequent joint replacement. These included:

Obesity: Being obese significantly increased the risk of needing another joint replacement, both in the contralateral joint and in a different joint.
Type of Initial Joint Replacement: Patients who underwent initial knee arthroplasty (TKA) had a higher risk of needing a contralateral joint replacement compared to those who had hip arthroplasty (THA). Conversely, those who had initial shoulder arthroplasty (TSA) were more likely to need a replacement in a different joint.
Age: Patients who required subsequent joint replacement of the contralateral joint tended to be younger at the time of their initial surgery.
Sex: Females were more likely than males to need a subsequent joint replacement of a different joint

It's important to note that these are just associations, and not everyone with these risk factors will necessarily need another surgery. However, understanding these factors can help patients and their doctors make more informed decisions about preventative measures and long-term management.

Taking Control of Your Joint Health: What Can You Do?

While some risk factors, like age and sex, are not modifiable, others, such as obesity, can be addressed through lifestyle changes. Maintaining a healthy weight through diet and exercise can significantly reduce the stress on your joints, potentially delaying or preventing the need for subsequent joint replacement. Regular consultations with your orthopedic surgeon and adherence to recommended physical therapy and rehabilitation programs are also crucial for optimizing joint health and function. By understanding the risks and taking proactive steps, you can empower yourself to achieve the best possible long-term outcome after joint replacement surgery.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2106/jbjs.17.00948, Alternate LINK

Title: Risk Of Subsequent Joint Arthroplasty In Contralateral Or Different Joint After Index Shoulder, Hip, Or Knee Arthroplasty

Subject: Orthopedics and Sports Medicine

Journal: Journal of Bone and Joint Surgery

Publisher: Ovid Technologies (Wolters Kluwer Health)

Authors: Joseph D. Lamplot, Anchal Bansal, Joseph T. Nguyen, Robert H. Brophy

Published: 2018-10-17

Everything You Need To Know

What is the likelihood of needing another joint replacement after the initial surgery?

The study revealed that nearly a quarter (23.6%) of patients required a replacement of the contralateral joint (the joint on the opposite side of the body) over a 5-to-8-year follow-up period. Additionally, 3.7% needed a replacement in a completely different joint. This highlights that subsequent joint replacement is more common than many might realize after undergoing shoulder, hip, or knee arthroplasty.

How does the type of initial joint replacement affect the chances of needing a second surgery?

The study identified differences based on the type of initial joint replacement. Patients who underwent initial knee arthroplasty (TKA) had a higher risk of needing a contralateral joint replacement compared to those who had hip arthroplasty (THA). Conversely, those who had initial shoulder arthroplasty (TSA) were more likely to need a replacement in a different joint. This suggests that the choice of initial surgery impacts the likelihood and location of future interventions.

What role does obesity play in the need for subsequent joint replacements?

Obesity significantly increases the risk of needing another joint replacement, both in the contralateral joint and in a different joint. This association emphasizes the importance of maintaining a healthy weight through diet and exercise. Reducing stress on the joints can potentially delay or prevent the need for a second surgery. This is a modifiable risk factor, offering patients a proactive way to manage their joint health.

Besides obesity, what other factors influence the need for a second joint replacement?

Besides obesity, age and sex also play a role. Patients who required subsequent joint replacement of the contralateral joint tended to be younger at the time of their initial surgery. Females were more likely than males to need a subsequent joint replacement of a different joint. The initial joint replacement type also matters, with knee arthroplasty patients having a higher risk of contralateral replacement, and shoulder arthroplasty patients more likely to need a replacement in a different joint.

What steps can I take to improve my long-term joint health after joint replacement surgery?

While some risk factors like age and sex are not modifiable, other factors like obesity can be managed. Maintaining a healthy weight through diet and exercise can reduce stress on your joints and may prevent the need for a second surgery. Regular consultations with your orthopedic surgeon, adherence to physical therapy, and rehabilitation programs are also crucial for optimizing joint health and function after shoulder, hip, or knee arthroplasty. Taking these proactive steps empowers you to achieve the best possible long-term outcome after joint replacement surgery.