Revision Joint 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 a variety of reasons. When this occurs, your knee can become painful and swollen. It may also feel stiff or unstable, making it difficult to perform your everyday activities.
If your knee replacement fails, your doctor may recommend that you have a second surgery — revision total knee replacement. In this procedure, your doctor removes some or all of the parts of the original prosthesis and replaces them with new ones.
Although both procedures have the same goal — to relieve pain and improve function — revision surgery is different than primary total knee replacement.
What Is Knee Replacement Revision Surgery?
Although today’s implants are designed to last many years, it’s possible
When a knee replacement no longer functions correctly, revision surgery is often required. During this procedure, a surgeon replaces the old device with a new one.
Revision surgery isn’t something to take lightly. It’s more complicated than a primary (or initial) total knee replacement (TKR) and entails many of the same risks. Nevertheless, it’s estimated that more than 22,000 knee revision operations are performed in the United States each year. Over half of these procedures take place within two years of the initial knee replacement.
Why revision surgery is more complicated than initial surgery
It’s important to note that a revision knee replacement doesn’t provide the same lifespan as the initial replacement (usually about 10 years rather than 20). The accumulated trauma, scar tissue, and mechanical breakdown of components lead to diminished performance. Revisions are also more susceptible to complications.
A revision procedure is typically more complex than the original knee replacement surgery because the surgeon must remove the original implant, which would have grown into the existing bone.
In addition, once the surgeon removes the prosthesis, there is less bone remaining. In some instances, a bone graft — transplanting a piece of bone transplanted from another part of the body or from a donor — might be required to support the new prosthesis. A bone graft adds support and encourages new bone growth.
However, the procedure requires additional preoperative planning, specialized tools, and greater surgical skill. The surgery takes longer to perform than a primary initial knee replacement.
If a revision surgery is necessary, you’ll experience specific symptoms. Indications of excessive wear or failure include:
- Diminished stability or reduced function in the knee
- Increased pain or an infection (which usually occurs soon after the initial procedure)
- A bone fracture or outright device failure
In other cases, bits and pieces of the prosthetic device may break off and cause tiny particles to accumulate around the joint.
