Revision Knee Surgery

When Total Knee Replacement Fails

Though it is usually a successful procedure with an implant that is designed to be durable for a very long time, there are some instances where a total knee replacement fails and a revision knee surgery is required:

Implant Issues – Though knee replacement components are securely fastened to bone during the initial surgery, they can become loosened over time. This can be due a number of reasons – from patients who received their initial knee replacement at a younger age and are living beyond the life of the knee implant, to engaging frequently in high-impact activities, gaining an excessive amount of weight or implant-related degenerative bone conditions.

Fracture – Because implanted knee components are attached or fuse to bone, a fracture (due to a hard fall or other traumatic event, for example) of that surrounding bone can result in a failure of the original knee replacement that will usually need to be corrected with revision knee surgery.

Infection – A risk of any surgical operation, infection of a knee implant can happen during the recovery time in the hospital, once you return home from surgery or in some cases, even years after the initial total knee replacement operation. When the infection affects the knee implant components, it can result in the inability of the knee to function properly and requires replacement through revision knee surgery.

Instability – In an original total knee replacement procedure, the implant is designed to work with your knee ligaments. If those ligaments become damaged or unstable at any point after the surgery, revision knee surgery may be required to correct the problem.

Rigidity – In some cases, total knee replacement may not be successful in helping you achieve a full range of motion for normal daily activities. This can be the result of too much scar tissue built up from the initial procedure. If attempts to eliminate the scar tissue using other methods are unsuccessful, a revision knee surgery may be required.

Am I a Candidate for Revision Knee Surgery?

If you have undergone a total knee replacement procedure and experienced issue with the implant, a fracture, infection instability or rigidity in the knee joint, you may be a candidate for revision knee surgery. An expert knee replacement specialist can help you decide which approach to treatment is best to get you back on the road to active, healthy living.

Revision knee surgery requires skill and expertise from an experienced orthopedic surgeon. The joint replacement team at Lakewood Regional Medical center is deeply committed to providing a comprehensive and individualized care plan to every patient who may be facing the need to undergo revision knee surgery. No matter what caused the initial total knee replacement to fail, each patient’s experience can be different in the way that the resulting knee pain or other symptoms present as well as the way that it affects the lifestyle you want to preserve or return to. We’re dedicated to aligning our treatment approach to your unique set of needs and circumstances.

As with any type of surgical procedure, revision knee surgery does involve risks. This procedure is longer and more complicated than a total knee replacement surgery and as such can increase the risk for complications, which may include: improper healing of the surgical wound, infection, reduced range of motion or stiffness in the knee, bleeding and blood clots, nerve damage, bone fracture during surgery and other problems such as heart attack, stroke or lung complications. Be sure to discuss all of your possible risks with your revision knee surgery specialist.

What to Expect Before Revision Knee Surgery

A number of knee pain tests and screenings will need to be conducted before undergoing revision knee surgery. Your doctor will obtain a medical history from you in order to evaluate your general health, how your total knee replacement is currently performing and the extent of your knee pain or instability. These evaluations will also include a physical examination to assess your range of motion, stability and knee strength. Lab tests, X-rays and other imaging exams may also be ordered to determine the precise location and extent of damage to the total knee replacement involved.

What to Expect During Revision Knee Surgery

When your doctor has obtained the results of all of the examinations ordered, your revision knee surgery date will be scheduled and communicated with you by your physician’s office. On the day of surgery, you will arrive to the hospital in advance of the procedure. Our compassionate and knowledgeable surgical staff will help prepare you for surgery in our pre-op area. Once preparation is complete, you will be wheeled into the operating room. Revision knee surgery is performed under general or spinal anesthesia and the total surgery time typically takes longer than total knee replacement, about 2-3 hours for most patients.

During the procedure, your surgeon will carefully remove the damaged portion of the total knee replacement, taking care to preserve as much healthy surrounding bone as possible. Once the damaged implant is removed, the surrounding surface will be prepared for the new revision knee implant. Surgery to insert the new knee implant is completed with repairs to any other surrounding tissue that is damaged.

What to Expect After Revision Knee Surgery

Once the revision knee surgery is complete, you will spend a short time in the surgical recovery room. From there, you will spend several days in the hospital, recovering in a special unit dedicated just for our joint replacement patients. During your recovery time you will be continuously monitored and will engage in a variety of activities designed to increase blood flow and encourage knee mobility. After discharge from the hospital, most revision knee surgery patients will need several days to weeks to fully recovery before returning to normal, low impact activities. It will also be important to follow your physician’s instructions for physical therapy to enhance the range of motion in your repaired knee.

Knee Pain Services

Knee Quiz

Quantify how knee pain is affecting your quality of life with our assessment.

Find an Orthopedic Specialist

Request one of our specialists to get a second opinion, or a really good first one.