Revision Total Knee Replacement
What We Do
What is the Revision Total Knee Replacement ?
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, It is a longer, more complex procedure that requires extensive planning, and specialized implants and tools to achieve a good result.
There are different types of revision surgery. In some cases, only one implant or component of the prosthesis has to be revised. Other times, all three components — femoral, tibial, and patellar — need to removed or replaced and the bone around the knee needs to be rebuilt with augments (metal pieces that substitute for missing bone) or bone graft, Damage to the bone may make it difficult for the doctor to use standard total knee implants for revision knee replacement. In most cases, The doctor will use specialized implants with longer, thicker stems that fit deeper inside the bone for extra support
When Revision Total Knee Replacement Is Recommended ?
Implant Loosening and Wear:
he cause of loosening is not always clear, but high-impact activities, excessive body weight, and wear of the plastic spacer between the two metal components of the implant are all factors that may contribute. Also, patients who are younger when they undergo the initial knee replacement may "outlive" the life expectancy of their artificial knee. For these patients, there is a higher long-term risk that revision surgery will be needed due to loosening or wear.
Instability:
If the ligaments around your knee become damaged or improperly balanced, your knee may become unstable. Because most implants are designed to work with the patient's existing ligaments, any changes in those ligaments may prevent an implant from working properly. You may experience recurrent swelling and the sense that your knee is "giving way." If knee instability cannot be treated through nonsurgical means such as bracing and physical therapy, revision surgery may be needed.
Infection:
If an artificial joint becomes infected, it may become stiff and painful. The implant may begin to lose its attachment to the bone. Even if the implant remains properly fixed to the bone, pain, swelling, and drainage from the infection usually make revision surgery necessary, Revision for infection can be done in one of two ways, depending on the type of bacteria, how long the infection has been present, the degree of infection, and patient preferences.
Fractures:
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. In determining the extent of the revision needed, your doctor will consider several factors, including the quality of the remaining bone, the type and location of the fracture, and whether the implant is loose. When the bone is shattered or weakened from osteoporosis, the damaged section of bone may need to be completely replaced with a larger revision component.