Understanding revision knee replacement surgery

Total knee replacement surgery helps to restore movement and reduce pain in knee joints affected by arthritis or injury. However, knee replacements can eventually wear out over time, just like a normal joint.

When this happens, revision knee replacement surgery will be needed in order to help you remain as mobile and pain-free as possible.

What is revision knee replacement surgery?

Revision knee replacement revision surgery is a surgical procedure carried out when a previous knee replacement has worn out or ‘failed’.

Total knee replacements are usually expected to easily last for 10+ years, although they can be affected/damaged by trauma, infection and age.

Any loss of function in the knee joint may lead to the need for a further operation, known as revision knee replacement surgery.

Your original total knee replacement surgery would have been carried out because the normal function of your knee was significantly altered or impaired through disease or trauma.

Your original surgery involved replacing the natural knee joint with an implant (sometimes referred to as a prosthesis) in order to restore function and mobility and to remove any pain that you were experiencing in your knee joint.

Should your original knee replacement now not be working as well as previously, your knee doctor (usually a consultant orthopaedic surgeon) may recommend that you have another operation to remove all or parts of your original implant and replace it with a newer one.

Revision knee replacement surgery will usually be a longer, more involved operation than your original total knee replacement surgery. The exact surgery carried out will be determined by your current implant; if only some parts of it have failed, they can sometimes be replaced without the need to remove and replace the entire implant. In other situations, the entire implant will need to be expertly removed and replaced.

Your total knee replacement would have been fixed in place securely, but over time it can sometime work a bit loose. Sometimes, the bones and/or soft tissues around the knee joint may be damaged and this can alter the stability of the implant. As a result, revision knee replacement surgery often requires the use of specialised implants (prostheses), as the ‘standard’ ones used in total knee replacement surgery are often not suitable for a second operation. 

For the surgery, you will be given a general anaesthetic, meaning you will not be conscious during the operation. Your surgeon will make a precise cut to give them access to the joint. They will expertly assess the state of your knee replacement and the soft tissues surrounding it, to ensure they are able to remove the current implant in the best way possible. If your original implant was fixed in place with a special cement, this will also be carefully removed at this time.

Once the original implant has been successfully removed, your surgeon will insert the new one into the optimal position, often using a series of surgical screws to help hold it in place. The joint will then be tested for range of motion and stability before the surgeon stitches up any incisions and places a wound dressing over your knee. You may have a small tube placed in your knee following surgery; this is known as a ‘drain’, as its function is to drain any excess fluid and/or blood from the site of the surgery.

Following your surgery, you will be taken to the recovery room, where out theatre staff will monitor you carefully while you wake up from the anaesthetic. 

Revision knee replacement surgery is a major procedure and it is important not to underestimate the length of time it may take you to fully recover. You will usually need to spend a couple of days in hospital after your surgery, where you will supported by our Knee Clinic specialists, including nurses, physiotherapists and occupational therapists, to ensure you are able to return home safely as soon as possible.    

Like all surgical procedures, knee revision surgery carries risks and the potential for complications. These include:

  • Infection in the knee joint,
  • Dislocation of the knee joint,
  • Bleeding inside the knee joint,
  • Damage to the nerves near the knee,
  • Formation of a blood clot (known as a ‘deep vein thrombosis’ or ‘DVT’).

The above risks are intended as guidelines only and are not exhaustive. We always recommend that you talk with your consultant about potential risks and complications before you decide to have any surgery.

The consultant-led orthopaedic Knee Clinic at St Joseph’s has vast experience in carrying out revision knee replacement surgery. Should you have previously undergone a total knee replacement and are now experiencing increased pain and/or stiffness in your knee joint, please contact us to arrange a consultation with one of our knee specialists who will be able to give you expert guidance on the best treatment options available for you.

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