Home · Second opinion in Sweden · Orthopaedics · Revision surgery
Second opinion when revision surgery is proposed
This page is for you if a second operation on a joint you have already had operated on has been raised in Sweden — a revision of a knee or hip replacement, or repeat surgery on the same area. A revision is a different decision from the original one, and the reasoning behind it deserves to be understood before you agree to it.
Quick answer
Revision surgery is generally more complex than the original procedure, carries a different risk profile, and often produces a more modest improvement. That makes one question decisive: what specifically is the revision expected to improve, and by how much. Needing a revision is usually not evidence that the first operation was done badly — prostheses wear, tissue heals differently, and revision is a recognised part of joint replacement over a long enough horizon. The document an assessment needs most is the operative report from the original surgery, which is often not in the records you can read digitally.
What an independent assessment is looking for
- Is the joint the source? Pain around a replaced joint can come from the spine, from adjacent soft tissue, or from a second problem the original condition was masking.
- Is there a mechanical explanation? Loosening, wear, malposition or instability each point in different directions.
- Has infection been excluded? This changes both the urgency and the type of surgery entirely.
- Was rehabilitation completed? An incomplete rehabilitation is a different situation from a completed one that did not help.
- What is the realistic gain? Stated as a specific improvement, not as "it should be better".
Why the framing matters here more than elsewhere
Patients considering a revision often arrive convinced that something was done wrong, and sometimes that is so. But an assessment that starts from that premise tends to examine the first operation and stop, when the useful assessment examines everything that could be producing symptoms now — including the possibilities that have nothing to do with the implant.
The practical version: bring the question "what is causing this and what are my options", not "was I let down". The first question gets a fuller answer, and if the second turns out to be warranted, the first will surface it anyway.
How Andrabedomning.se fits in
Andrabedomning.se is an independent Swedish patient guidance service. You describe your situation in a request — in English — and a person reads it and replies, normally within one working day, with information about relevant specialist contact. If we cannot help, you get an explanation of why and where to turn instead. We do not diagnose or provide medical care. Records go directly to the care provider, never to us.
Sending a request is free and commits you to nothing. If we can coordinate a suitable specialist contact, two amounts are disclosed to you in writing before anything is booked: our coordination fee (samordningsavgift), which is our only source of revenue, and the specialist's fee, which is set by the care provider and paid directly to them. We take no commissions or referral fees from specialists or clinics. How it works in full →
Andrabedomning.se coordinates the contact. The medical assessment is made by the specialist and care provider you choose.
Frequently asked questions about revision surgery
Does needing a revision mean the first operation was done badly?
Usually not. Prostheses have a finite service life and wear over time; tissue heals differently in different people; and some revisions follow injury or infection rather than anything about the original procedure. Revision is a recognised part of joint replacement over a long enough horizon, not by itself evidence of error. Framing it as error also narrows the assessment, because it directs attention to the first operation rather than to the current situation.
How is a revision decision different from the first one?
It is generally a more complex operation with a different risk profile, and the expected result is often more modest than after a primary procedure. That makes the threshold question sharper: what specifically is the revision expected to improve, and by how much. A clear answer to that is the single most useful thing to obtain before consenting.
What material does a revision assessment need?
The operative report from the original surgery, which describes what was implanted and what was found; imaging before and after; the record of your post-operative course and rehabilitation; and any investigations done since. The operative report is the crucial document and is often not included in records available digitally — request it explicitly by name.
Could the pain be coming from something other than the joint?
It can, and this is one of the main things an independent assessment is looking for. Pain around a replaced joint may originate in the spine, in adjacent soft tissue, or in a second problem that the original condition was masking. Establishing the source is the step that decides whether revision is the right intervention at all.
Should I go back to the original surgeon?
Usually yes, first — they hold information nobody else does about what was done and found. An independent assessment becomes valuable when you have been back, the explanation has not changed, and your symptoms have not either. Many revision decisions are made jointly, with the original surgeon and an independent view both on the table.
Is there a time pressure on the decision?
It depends on the cause. Where infection or a loosening implant is suspected, timing matters and the assessment should not be delayed. Where the question is persistent pain with a stable implant, there is usually room to take the decision carefully. Ask which situation you are in — it is a question with a definite answer.
Sources
- Svenska Ledprotesregistret (Swedish Arthroplasty Register) — national outcome and revision data for hip and knee replacement in Sweden, including how implant survival is followed over time.
- 1177 — Skelett, leder och muskler — general descriptions of joint conditions, joint replacement and post-operative course.
- 1177 — Din journal — access to your own records, including the operative report from the original surgery.
- Patient Act (patientlagen 2014:821), chapter 9, section 1 — the right to choose a publicly funded outpatient provider in any Swedish region for an assessment.
Editorially produced by Andrabedomning.se from the primary sources above. Sources last checked: 4 August 2026.
Related pages
- Still in pain after surgery
The page for when the cause has not been established yet.
- Orthopaedic second opinion in Sweden
Routes, material and what an assessment can settle.
- Before a hip replacement
Where the expected life of a prosthesis enters the first decision.
- Getting the operative report
The document a revision assessment cannot do without.
Has a second operation been raised?
Describe your situation in a few sentences and tell us which assessment or recommendation you have already received. Sending a request is free. If we can coordinate a suitable specialist contact, our coordination fee and the specialist's separate fee are disclosed in writing before you decide whether to book.
Describe your orthopaedic case
In an emergency, call 112. For non-urgent medical advice, call 1177.