Revision Knee Replacement Surgery

Revision Knee Replacement Surgery

Overview

During primary total knee replacement, the knee joint is replaced with an implant, or prosthesis, made of metal and plastic components. Although most total knee replacements are very successful, over time, problems such as implant wear and loosening may require a revision procedure to replace the original components.

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, he or she will use specialized implants with longer, thicker stems that fit deeper inside the bone for extra support.

Who needs knee revision surgery?

A knee revision may be necessary for anyone whose prosthetic knee implant fails due to injury or wear, or who gets an infection in the area around implant. In elderly people who have a knee replacement, the artificial knee implants may last for life. But in younger patients, especially those who maintain an active lifestyle, knee prostheses may eventually fail, requiring a second replacement later in life.

The most common reasons people for knee revision are:

  • Infection: The risk of infection from a total knee replacement is less than 1%, but when infections do occur, a knee revision of one kind or another is necessary.
  • Instability: This occurs when the soft tissues around the knee are unable to provide the stability necessary for adequate function while standing or walking.
  • Stiffness: In some patients, excessive scar tissue may build up around the knee and prevents the joint from moving fully.
  • Wear and tear: This can include loosening or breakage of prosthesis components due to friction over time
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