Revision knee replacement
Most knee replacements last many years, but some need further surgery. A revision replaces part or all of an existing knee replacement.
Reasons for revision
- Loosening or wear of the implant
- Infection
- Instability, where the knee feels wobbly or gives way
- Stiffness
- Fracture around the implant
- Progression of arthritis after a partial knee replacement
Assessment
A painful knee replacement needs careful investigation to find the cause. This may include X-rays, CT scans, blood tests and sometimes a sample of joint fluid or tissue. Understanding the cause is essential, as revision surgery helps most when there’s a clear problem to correct.
Surgery
Revision surgery is more complex than a first-time replacement. It may need specialised implants, bone grafts or, for infection, surgery in two stages.
Due to the complexity of the surgery and increased risks involved, all patients who choose to have a revision knee replacement will first be discussed at a regional multi-disciplinary team meeting to decide whether this is the right management plan to proceed with.
Where it benefits the patient, I operate alongside a consultant colleague.
Recovery
Recovery is generally longer than after a first replacement, and depends on the reason for revision. Most people need walking aids for several weeks and a longer course of physiotherapy.
Risks
Risks are higher than for a first knee replacement and include infection, stiffness, instability, blood clots and the need for further surgery. We’ll discuss these in detail.