Prosthesis Revision and Infection Specialist in Guatemala
When the first surgery didn’t work, you need someone who knows why.
A failed prosthesis, a periprosthetic infection, or aseptic loosening aren’t the end of the road. They’re the start of a more specialized evaluation — with judgment, experience, and specific training.
When should you consult Dr. Arriola?
You had hip or knee surgery and the pain never went away or came back
Your prosthesis creaks, hurts, or you feel something isn’t working right
You were diagnosed with a prosthesis infection and don’t know how to proceed
X-rays show the prosthesis is loosening
You had fever, redness, or drainage at the surgical site
You want a second opinion on your prosthesis before deciding whether to have surgery again
⚡ Consultations Monday to Friday 10:00 AM–4:00 PM | Saturdays 8:00 AM–1:00 PM | By appointment only
2025
Diploma in Periprosthetic Infections — Catholic University of Argentina
3
countries of specific training — Guatemala, Israel, and Argentina
5+
years of experience in Trauma and Orthopedic Surgery
Q300
initial consultation with complete case evaluation
Solutions for failed prostheses and infections
Every revision case is unique. Dr. Arriola designs the treatment plan based on the exact cause of the failure — not on generic protocols.
Failed Knee Prosthesis Revision
Knee arthroplasty revision surgery
Evaluation and revision surgery for knee prostheses with mechanical, infectious, or functional failure. Complete differential diagnosis before any surgical intervention.
Main benefits:
- Precise diagnosis of the cause of failure before operating
- Revision surgery with high-fixation implants
- Management of periprosthetic bone stock
- Complete follow-up through functional recovery
Recovery time
3-6 months
A failed knee prosthesis has multiple possible causes — mechanical, infectious, instability. Operating without identifying it first is the most costly mistake.
“Before any revision, I need to know exactly why the first surgery failed. Without that diagnosis, the second one can fail too.”
— Dr. Roberto Arriola
Failed Hip Prosthesis Revision
Hip arthroplasty revision surgery
Evaluation and revision surgery for hip prostheses with loosening, infection, instability, or wear. Documented experience with high-complexity cases, including patients with surgeries performed abroad.
Main benefits:
- Complete differential diagnosis of the cause of failure
- Revision surgery with implants and technique appropriate for each case
- Management of bone stock and soft tissue
- Follow-up through recovery of functional mobility
Recovery time
3-6 months
Hip revision is technically more complex than primary surgery. It requires specific arthroplasty experience — not every orthopedic surgeon performs it.
“I’ve treated patients with failed surgeries performed here and abroad. In most cases there was an identifiable cause and a viable solution.”
— Dr. Roberto Arriola
Periprosthetic Infections
Specialized diagnosis and management
Diagnosis and treatment of hip and knee prosthesis infections — acute and chronic. One-stage or two-stage revision protocol based on the type of infection. Specific diploma — Catholic University of Argentina, 2025.
Main benefits:
- Precise differential diagnosis: infection vs. aseptic loosening
- Antibiotic protocol tailored to the identified microorganism
- One-stage or two-stage revision surgery depending on the case
- Diploma in Periprosthetic Infections — specific training
Recovery time
3-12 months depending on protocol
Chronic prosthesis infection often requires a two-stage revision — removing the implant, placing an antibiotic spacer, and later reimplantation. It is the most demanding protocol in joint surgery.
“Periprosthetic infections are the most complex complication in joint surgery. That’s why I pursued the specific diploma — because empirical management isn’t enough.”
— Dr. Roberto Arriola
Aseptic Prosthesis Loosening
No infection — mechanical implant failure
Evaluation and management of aseptic loosening — the prosthesis separating from the bone without infection. Diagnosis with imaging and lab work, revision surgery plan with higher-fixation implants.
Main benefits:
- Differential diagnosis confirmed with lab work
- Revision plan with an implant suited to the available bone stock
- Management of periprosthetic osteolysis when applicable
- No need for a prolonged antibiotic protocol
Recovery time
3-6 months
Aseptic loosening and infection look similar in symptoms but are treated in completely different ways. Confirming which one it is — with lab work — is the step that defines everything that follows.
“Operating on a loosening as if it were an infection, or an infection as if it were a loosening, are mistakes that come at a very high cost. Lab work isn’t optional.”
— Dr. Roberto Arriola
Second Opinion in Revision Surgery
Independent review before deciding
Independent evaluation of a failed prosthesis or a proposed revision surgery plan. Dr. Arriola reviews the complete case, identifies the cause of failure, and issues a report with treatment options.
Main benefits:
- Independent review with up-to-date judgment
- Identification of the cause of failure when it isn’t clear
- Evaluation of the proposed revision plan
- Documented report to make an informed decision
A second surgery is a major decision. Before accepting it, it’s worth getting an independent evaluation that confirms the diagnosis of the cause and that the proposed plan is correct.
“Being recommended for a revision doesn’t mean it’s urgent or that it’s the only option. First, you need to fully understand why it failed.”
— Dr. Roberto Arriola
Symptoms that require a specialized evaluation.
A failing prosthesis rarely fails suddenly. There are usually signs that something isn’t working right — and they require evaluation before the problem gets worse.
Pain that never went away after surgery
If pain didn’t improve after replacement surgery, or came back after a period of improvement, it may indicate periprosthetic infection, loosening, or a mechanical problem with the implant.
Fever, redness, or warmth at the surgical site
Classic signs of periprosthetic infection. Infection can present acutely — within the first few weeks — or chronically, months or years after surgery.
Drainage or a wound that won’t close
Any drainage from the surgical scar, a wound that isn’t closing properly, or a fistula near the prosthesis should be urgently evaluated as a possible periprosthetic infection.
A feeling that the prosthesis is moving or loose
A sensation of abnormal prosthesis movement, clicking, or joint instability may indicate aseptic loosening — the prosthesis separating from the bone without infection.
Pain when putting weight on the joint
Mechanical pain when bearing weight on the operated hip or knee — especially if it was functional before — may indicate loosening or a periprosthetic fracture.
Elevated inflammatory markers with no apparent cause
Elevated CRP, ESR, or white blood cell count on lab work in a patient with a prosthesis should be evaluated to rule out periprosthetic infection, even without obvious local symptoms.
Imaging showing loosening or periprosthetic changes
Radiolucent lines, periprosthetic osteolysis, or implant migration on X-ray or CT scan require a specialized orthopedic evaluation to determine the cause and treatment plan.
Revision surgery recommended without a clear diagnosis of the cause
If you’ve been recommended a second surgery without a clear explanation of why the first one failed, that’s reason enough to seek a specialized second opinion.
Do you identify with any of these?
A first consultation is enough to begin studying your case and define the next steps
How a failed prosthesis is evaluated in consultation
The differential diagnosis in a failed prosthesis is the most important step — and the most frequently skipped one. It requires combining clinical findings, imaging, and lab work before any surgical decision.
Complete case review
Detailed medical history, review of the original surgical report, implants used, post-operative course, and treatments received. Understanding what was done and when is the starting point.
Updated imaging evaluation
Comparative X-rays, CT scan, and when applicable, MRI with a metal-specific protocol. Looking for loosening, osteolysis, periprosthetic fracture, implant migration, or fluid collections.
Specialized lab work
CRP, ESR, blood count, and when applicable, joint aspiration with culture and cell count. The differential diagnosis between infection and aseptic loosening depends largely on these studies.
Classification of the type of failure
With complete clinical findings, imaging, and lab work, the type of failure is classified — infectious, mechanical, wear-related, instability, or combined. This classification determines the treatment.
Revision surgery plan
Design of the surgical plan — one-stage or two-stage revision, type of revision implant, antibiotic management — tailored to the type of failure, the condition of the bone, and the patient’s status.
Documented second opinion when applicable
For patients seeking confirmation before deciding, Dr. Arriola issues a complete clinical report with the diagnosis of the cause of failure and the available treatment options.
Why consult Dr. Arriola for prosthesis revision or infection?
Diploma in Periprosthetic Infections
Periprosthetic infections are one of the most complex complications in joint surgery. Dr. Arriola has a specific diploma in their management — a level of training few orthopedic surgeons in Central America have.
Differential diagnosis before operating
The most costly mistake in prosthesis revision is operating without knowing exactly why the first one failed. Dr. Arriola performs the complete differential diagnosis — clinical findings, imaging, and lab work — before any surgical decision.
Arthroplasty subspecialty trained in Israel
Revising an arthroplasty demands the same technical level — or higher — as primary surgery. Dr. Arriola has an arthroplasty subspecialty trained at Barzilai Medical Center, Israel, with experience in complex cases.
Time and clarity for cases that require detailed explanation
Patients with failed prostheses often arrive with a lot of uncertainty and accumulated questions. Dr. Arriola dedicates 45 to 60 minutes to reviewing the complete case and explaining the diagnosis and options clearly.
Diploma in Periprosthetic Infections
Periprosthetic infections are one of the most complex complications in joint surgery. Dr. Arriola has a specific diploma in their management — a level of training few orthopedic surgeons in Central America have.
Differential diagnosis before operating
The most costly mistake in prosthesis revision is operating without knowing exactly why the first one failed. Dr. Arriola performs the complete differential diagnosis — clinical findings, imaging, and lab work — before any surgical decision.
Arthroplasty subspecialty trained in Israel
Revising an arthroplasty demands the same technical level — or higher — as primary surgery. Dr. Arriola has an arthroplasty subspecialty trained at Barzilai Medical Center, Israel, with experience in complex cases.
Time and clarity for cases that require detailed explanation
Patients with failed prostheses often arrive with a lot of uncertainty and accumulated questions. Dr. Arriola dedicates 45 to 60 minutes to reviewing the complete case and explaining the diagnosis and options clearly.
Ready to get your mobility back?
Book your consultation and take the first step toward a life without pain
Specialized Orthopedic Care in Zona 14
Dr. Roberto Arriola - Traumatólogo y Ortopedista
10 calle A 2-30, Zona 14. Edificio Prospere 14, 5to Nivel, Oficina 509Modern office with wheelchair access in the heart of Zona 14, Guatemala City
Office Hours
Monday to Friday from 10:00 AM to 4:00 PM Saturday from 8:00 AM to 1:00 PM
Emergency Care
Hip and femur fractures and prosthesis emergencies
Coverage Areas
Guatemala City
- • Zona 14, 10, 15
- • Zona 9, 13, 4
- • Cayalá and Oakland Mall area
Metropolitan Area
- • Mixco
- • Villa Nueva
- • Santa Catarina Pinula
- • Carretera a El Salvador
Patients from Outside the Capital
- • Care for patients from all of Guatemala
- • Telehealth available in select cases
- • Coordination with referring physicians from outside the capital
Common questions, clear answers
Still have questions? Let’s talk directly on WhatsApp for personalized answers.