What is a Complex Reconstruction?

From revising a failed previous joint replacement to addressing significant bone loss, complex reconstruction surgeries are among the most challenging in orthopedic surgery. The experts at Baylor Scott & White Greater Dallas Orthopaedics are dedicated to providing advanced care for the most complex cases including complex reconstructions.

In this blog, we’ll discuss what complex reconstructions are and some of the most common reasons a patient may require one. As always, this is not a substitute for medical advice and this overview is not comprehensive.

What is a Complex Reconstruction?

In short, a complex reconstruction is an orthopedic surgery performed to substantially repair a bone, joint, or prosthesis that is failing and significantly impacting the quality of life of an individual.

An important distinction is that standard joint replacements are not considered a complex reconstruction, but a revision to a failed or infected joint replacement is. An initial joint replacement can be viewed as an alternative to the complex reconstruction of a joint.


What are Common Cases when a Complex Reconstruction is Recommended?

It’s important to put the word “common” in context here. Complex reconstructions themselves are exceedingly rare in general, as are the ailments that require them to be utilized. For example, joint replacements are very reliable procedures, and clinics like ours perform numerous replacements every year. With that said, when these rare procedures are required, these are among the most common reasons:


Failed Joint Replacement

Replacement joints fail for numerous reasons, including the loosening of, fracture around, and malposition of the implants, as well as dislocations, wound complications, tendon tears, limb length inequality, and loss of function. The most common joints that are replaced, and thus the most common failed joint replacements, are the shoulder, elbow, hip, and knee.

Prosthetic Joint Infection (PJI)

Again, to put “common” in context, PJI occurs in just roughly 1% of joint replacements. The diagnosis and treatment of PJI can be complicated, but our team treats numerous of PJI cases annually.


A doctor looking at a patients' knee joint


Massive Bone Loss

Large amounts of bone can be lost in the setting of tumor, infection, trauma, or complications of previous surgery. There is no one-size-fits-all solution for massive bone loss, as there are numerous factors to consider, like which bone is being affected, its proximity to a joint, the degree of bone loss, and any additional underlying conditions.


Bone and joint infections are particularly difficult to manage, but it’s important that they are promptly and properly managed to prevent lasting complications. The surgical procedures associated with bone and joint infections are tedious and require a nuanced approach.

Failed Orthopedic Surgery

Previous surgeries can result in complex situations requiring the use of advanced and sophisticated surgical techniques to restore function and an elevated quality of life.

Limb-Sparing Surgery

Patients are often offered amputations for their complex orthopedic ailments, but it is frequently possible to save these limbs with advanced surgical procedures that provide patients a higher quality of life than an amputation would afford them.

Nonunion of Fractures

A fracture that doesn’t heal correctly can cause significant pain and trouble with mobility. Surgery to fix these complex fractures can be demanding, but a team proficient in these procedures can help restore function for patients.

We hope you found this overview insightful and have gained a more detailed understanding of what complex reconstructions are, when they are recommended, and how important it is that they’re performed by a team with significant experience. If you or a loved one is suffering from significant bone, joint, or soft tissue pain, especially if it’s related to a tumor, we recommend you reach out to the experts at Baylor Scott & White Greater Dallas Orthopaedics today!

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