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CION Cancer Clinics
How long does an endoprosthesis last, and what happens when it fails? | CION Cancer Clinics
Many years, often well beyond a decade, but not for life. A tumour endoprosthesis is a large metal implant under daily load, and a fair share of people need a further operation on it at some point, especially the young and active and those with a knee implant. This page explains how implants fail, what a revision involves, and what you can do to make yours last. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- How long does an endoprosthesis actually last?
- The four ways an implant can fail
- What a revision operation usually involves
- What is usual with an implant, and what needs a call
- Four things families tell us, and what is actually true
- What helps an implant last, and what this page cannot tell you
- Common questions about how long an implant lasts
The short answer
How long does an endoprosthesis actually last?
Many years, often well beyond a decade, but not for life. An endoprosthesis is a large metal implant under daily load, and a fair share of people need a further operation on it at some point, more so if they are young and active or if the implant is at the knee. Planning for that from the start is more useful than any single figure.
Why this page gives no single number
Published figures vary widely with the site of the implant, the person's age, the design used, how it was fixed and whether chemotherapy or radiotherapy was given. A figure that fits a middle-aged person with a hip implant tells a teenager with a knee implant very little. Your surgeon can give you their own experience for your implant, which is more useful than a website average.
What "lasting" actually means
An implant can still be in place and yet not be working well, and an implant that needed a part exchanged can go on for many years after. When surgeons talk about how long an implant lasts, they mean the time before a major part has to be replaced. It says nothing about the cancer.
Who tends to need earlier revision
Children and young adults, because they load the implant hard and for longer. Knee implants more than hip or shoulder, because the knee hinge takes the most stress. And anyone whose implant has had an infection, because that is the failure that is hardest to settle.
This page describes how implants wear and fail. It cannot tell you how long yours will last.What goes wrong
The four ways an implant can fail
Each has its own signs and its own fix. Knowing them helps you report the right thing at the right time.
Infection
Bacteria settle on the metal, where the body cannot clear them. It can happen soon after surgery or years later, often after a chest, dental or urine infection elsewhere.
Signs
- Redness, warmth or leaking at the scar
- New pain, fever or feeling unwell
Loosening
The stem that anchors the implant in the bone slowly works loose, without any infection. The joint starts to feel unsteady and aches with weight-bearing.
Signs
- A deep ache that builds with walking
- A change seen on a routine X-ray
Wear and breakage
The plastic bushings inside a hinged knee wear down, and very occasionally a metal part fatigues and breaks. Wear is slow and is usually picked up at follow-up before it causes trouble.
The cancer returning nearby
A recurrence, meaning the tumour coming back in the same area, is not a failure of the implant but it can mean the implant has to come out. This is why follow-up scans look at the tissue around it.
New pain is not usually recurrence. It still needs a check.Not sure whether this applies to you?
Ask an oncologistIf it comes to it
What a revision operation usually involves
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The problem is found
Either you report new pain, swelling or unsteadiness, or a routine X-ray shows a change. Either way, the surgical team wants to know early rather than late.
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Tests to find the cause
Blood tests for infection, scans of the implant and sometimes a sample of fluid from around the joint. The aim is to separate infection from loosening, because the operations differ.
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Planning the operation
Sometimes only one part, such as the hinge or the bushings, needs exchanging. Sometimes the whole implant comes out. Infection may need two operations, with a gap for antibiotics between them.
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The revision itself
Usually a shorter recovery than the first operation, because no tumour is being removed. The muscles around the implant are already rebuilt, and physiotherapy restarts from a higher base.
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Back to follow-up
A revised implant is checked in the same way as the first one, with X-rays and scans over the years. Most people return to the level of walking they had before the problem.
Knowing the difference
What is usual with an implant, and what needs a call
Usual, mention it at follow-up
Not usual, call the team
Stiffness first thing, easing with movement
A joint that has become unsteady or gives way
A faint click from the hinge
A new grinding, or a sudden change in how it feels
Mild aching after a long day on your feet
A deep ache that builds with every step and does not settle
A scar that is pale, flat and not tender
Redness, warmth, swelling or leaking at the scar, or a fever
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Did you know
The X-ray at each follow-up is checking the implant itself, not only looking for cancer. Loosening shows as a thin dark line around the stem long before it causes pain, which is why keeping the appointment matters even when the limb feels fine.
Commonly believed
Four things families tell us, and what is actually true
"If the leg hurts, the cancer must have come back."
Most new pain around an implant is mechanical: loosening, wear or a muscle strain. Recurrence is one cause among several and not the commonest. It still needs a check, and a scan will usually settle the question quickly.
"Needing a revision means the first operation was done badly."
Implants wear because they are used. A revision after years of walking on an implant is the expected course, not a sign of error. Surgeons who fit these implants plan for revisions from the day of the first operation.
"The implant is fine, so we can stop the follow-up visits."
Loosening and wear are silent for a long time and are picked up on X-ray before they are felt. Stopping follow-up means the first sign is a broken or badly loosened implant, which is a much bigger operation to fix.
"With an implant, all sport is over for good."
Swimming, cycling and walking are usually encouraged. Running, jumping and contact sport put repeated shock through the hinge and are usually advised against. Ask your surgeon what your implant and site allow, and build up gradually.
In your hands
What helps an implant last, and what this page cannot tell you
You cannot control the design or the site, but you can control the load and the infection risk. Keeping your weight steady, avoiding impact sport and building the muscles around the implant all reduce the stress on the hinge and the stem.
Guarding against infection
Tell every dentist and doctor that you have a tumour implant, because infections elsewhere can seed onto the metal. Treat skin, dental, chest and urine infections promptly rather than waiting. Keep the scar clean and report any change in it early. Never start antibiotics from a pharmacy for a hot or leaking scar; see the surgical team instead.
What this page cannot tell you
It cannot tell you how long your implant will last, whether you will need a revision, or when. It cannot tell you whether a new pain is serious. It can only tell you what to watch for and why the follow-up matters.
Ask your surgeon for their own figures for your implant and site, and ask what a revision would involve if it came to it.Questions we are asked
Common questions about how long an implant lasts
Will my son need another operation on the implant in his lifetime?
Quite possibly, and it is sensible to expect it. Young, active people load an implant hardest and for longest, and many need at least one revision over the decades. That does not mean the first operation was wrong. It means the implant did years of work and a part needs exchanging.
Does a revision mean the whole implant comes out?
Not always. Worn bushings or a damaged hinge can often be exchanged while the stems stay in the bone. A loose stem or an infected implant usually means more of it is removed. The tests beforehand are aimed at deciding exactly how much needs to change.
Is an infection years later really possible?
Yes. Bacteria from an infection elsewhere in the body can travel in the blood and settle on the metal, where the immune system cannot clear them. This is why you should tell every doctor and dentist about the implant and treat other infections promptly.
How often should the implant be checked?
Your surgical team will set a schedule that starts frequent and spaces out over the years. In the early years the visits are also checking for the cancer, so they are combined. Do not drop the implant checks when the cancer visits become less frequent; ask what the long-term schedule is.
Can a broken implant be fixed, or is it amputation then?
A broken implant is usually revised, not amputated. The damaged part is removed and replaced. Amputation after a failed implant is uncommon and is mostly considered when infection cannot be cleared despite repeated operations, or when the cancer has returned in the area.
Does chemotherapy or radiotherapy shorten the life of the implant?
They can affect how well the bone and soft tissue around the implant heal and hold, and radiotherapy to the area raises the infection risk. Neither means the implant will fail. It means the team watches more closely, and it is one reason your surgeon's own figures matter more than a general average.
Will the revision operation cost as much as the first?
It varies with how much of the implant is exchanged. A bushing change is a smaller operation; a full exchange for infection can be larger and longer. Aarogyasri, CGHS, ECHS and EHS and cashless insurance may cover revisions within their limits, but the implant component is often handled separately. Ask before the operation.
Can I get the implant checked at CION if it was fitted elsewhere?
Yes. Bring the operation note, the implant details and every X-ray since, so the team can compare like with like. A change on X-ray is only meaningful against the earlier films. Call the helpline and we will tell you what to bring and arrange the appointment.
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Sources
- Cancer Research UK — Treatment for bone cancer
- American Cancer Society — Surgery for osteosarcoma
- NHS — Bone cancer: treatment
- Macmillan Cancer Support — Bone cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Endoprosthetic Replacement After Bone Tumour RemovalWhat the implant is and how it is fittedGrowing Prostheses for ChildrenWhy implants in children carry more operations over a lifetimeAllograft and Biological ReconstructionThe alternative that rebuilds with bone rather than metalComplications and Red FlagsWhat needs same-day care after any cancer operationCost, Insurance and Schemes for Cancer SurgeryHow Aarogyasri and insurance treat implants and revisions
Talk to us
Worried about an implant that has started to hurt?
Bring the operation note and every X-ray since, or call the helpline. A surgical oncologist will compare the films and tell you whether it needs a closer look. One helpline serves every CION centre.