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Revision Total Knee Replacement

Helping you feel better

What is  knee replacement revision surgery?

Also known as revision total knee arthroplasty, knee replacement revision surgery is a procedure in which the surgeon removes a previously implanted artificial knee joint, or prosthesis, and replaces it with a new prosthesis.

Knee revision surgery may also involve the use of bone grafts.

Revision knee replacement

Signs and Symptoms of a knee replacement failure

Revision knee replacement, Removal of loose bodies

A failed knee implant may show signs of mild soreness to severe pain, instability, swelling and stiffness across the entire knee (generalized) or in a small section (localized).

Other symptoms are:

  • Fever, chills, and muscle ache, indicating the presence of infection.

  • Mobility issues, including reduced range of motion and knee stiffness.

  • Swelling resulting from the inflammation of the lining of the knee.

  • Effusion, or excess fluid in the knee.

Importance of  Revision knee replacement

Total knee replacement is one of the most successful procedures in all of medicine. In the vast majority of cases, it enables people to live richer, more active lives free of chronic knee pain. Over time, however, a knee replacement may fail for the following reasons

  • Instability – This means the knee is not stable and may be giving way or not feel safe when you walk.
  • Loosening of either the femoral, tibial or patella component – If the implants lose their attachment to the bone there is micromotion that causes pain. Revision is required.
  • Osteolysis (bone loss). This can occur due to particles being released into the knee joint that result in bony erosion and loosening of the implants
  • A periprosthetic fracture is a broken bone that occurs around the components of a total knee replacement. These fractures are most often the result of a fall, and usually require revision surgery.
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Medical Evaluation

After a thorough physical examination to make sure that you are healthy enough to have the surgery and complete the recovery process, your doctor will usually order imaging tests to learn more about the condition of your knee.

  • X-rays. These provide images of dense structures such as bone. Your doctor may order X-rays to  taken around the area of the joint replacement to look for loosening or a change in the position of the components.

Laboratory tests. To determine whether you have an infection, your doctor may order blood tests. He or she may also aspirate your knee. In this procedure, joint fluid is removed using a needle and syringe, then analyzed in a laboratory to determine if infection is present.

Revision knee replacement, Minimally invasive Spinal surgery, Kienbocks disease

Your Surgical Procedure

Revision knee replacement

Each knee is individual and knee replacements take this into account by having different sizes for your knee. If there is more than the usual amount of bone loss sometimes extra pieces of metal or bone are added.

Surgery is performed under sterile conditions in the operating room under spinal or general anesthesia.

Most Revision knee replacement  take longer to perform than primary procedures (about two to three hours). The first step is removal of the implant.

If there has been significant bone loss, bone grafts may be required to fill the voids. Bone grafts can be either autograft (your own bone taken from another site of your body) or an allograft (bone tissue from another person obtained from a bone bank).

In some cases, metal wedges, wires or screws may be used to strengthen the bone. Finally, specialized revision knee implants are inserted.

Temporary drains are usually placed to collect any fluids or blood that may remain after surgery

Pain relief treatment

Recovery after Revision knee replacement

Post-operative care after knee Revision knee replacementis similar to the care of a primary knee replacement. This includes a combination of physical therapy, blood management, and pain medication as necessary.

Antibiotics and some method of blood clot prevention will be continued in the postoperative period. A brace or splint may be used to protect the joint after the surgery.

Recovery time after Revision knee replacement  varies; some patients take longer to recover. In most cases, physical therapy will be initiated within 24 hours of the procedure.

Assistive devices, such as a walker or crutches, will be used early in the convalescence period, and patients will progress to a cane or walking without any assistance as their condition improves.

Revision knee replacement
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Risks & Complications associated with revision knee replacement surgery

Any surgery can have potential complications. Because the procedure is longer and more complex than primary total knee replacement, it has a greater risk of complications. Before your surgery, your doctor will discuss each of the risks with you and will take specific measures to help avoid potential complications.

The possible risks and complications of Revision knee replacement include:

  • Poor wound healing
  • Reduced range of motion or stiffness in the knee
  • Infection in the wound or the new prosthesis
  • Bleeding
  • Blood clots
  • Bone fracture during surgery
  • Damage to nerves or blood vessels
  • Pulmonary embolism—a blood clot in the lungs
  • Medical problems such as heart attack, lung complications, or stroke

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