Revision replacement surgery is more complex than an initial replacement operation and requires a certain level of skill and experience. It is a surgical procedure in which all or part of a previously implanted hip/knee joint is replaced with a new artificial joint and includes:

  • Total femur & humerus replacements
  • Treatment of Infected Hip and Knee Replacements
  • Treatment of Peri-prosthetic Fractures
  • Treatment of Chronic Osteomyelitis

This article focuses on Revision Knee Replacement.

Revision Knee Replacement

Revision knee replacement surgery involves replacing part or all of your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require second revision surgery.

Indications for Revision Knee Replacement

Revision knee replacement surgery may be advised to patients if they have one or more of the following conditions:
  • Trauma to the knee joint
  • Chronic progressive joint disease
  • Increased pain in the affected knee
  • Worn out prosthesis
  • Knee instability or a feeling of giving way while walking
  • Loosening of the prosthesis
  • Infection in the prosthetic joint
  • Weakening of bone around the knee replacement, a process known as osteolysis (bone loss)
  • Stiffness in the knee
  • Leg length discrepancy
  • Fracture

What Does the Procedure Entail?

Revision knee replacement surgery may involve the replacement of one or all the components.

The surgery is performed under general anaesthesia. Your surgeon makes an incision over the knee to expose the knee joint. The kneecap along with its ligament may be moved aside so that there is enough room to perform the operation. Then the old femoral component of the knee prosthesis is removed. The femur is prepared to receive the new component. In some cases, the damaged bone is removed and a bone graft or a metal wedge may be used to make up for the lost bone.

Next, the tibial component along with the old plastic liner is removed. The damaged bone is cut and the tibia is prepared to receive the new component. Like the femur, the lost bone is replaced either by a metal wedge or bone graft. Then, a new tibial component is secured to the end of the bone using bone cement. A new plastic liner will be placed on top of the tibial component. If the patella (kneecap) has been damaged, your surgeon will resurface it and attach a plastic component. The tibial and femoral components of the prosthesis are then brought together to form the new knee joint, and the knee muscles and tendons are reattached. Surgical drains are placed for the excess blood to drain out and the incision is closed

What Are the Risks?

Like all major surgical procedures, there may be certain risks and complications involved with revision knee replacement surgery.

The possible complications after revision knee replacement include:

  • Stiffness in the knee
  • Infection
  • Bleeding
  • Formation of blood clots in the leg veins
  • Injury to nerves or blood vessels
  • Prosthesis failure
  • Patella (kneecap) dislocation
  • Ligament injuries

How Long Does it Take to Recover From a Knee Replacement Revision?

It may take up to 12 months to fully recover from your Revision Knee Replacement Surgery. Most people will feel comfortable going back to work and resuming some of their normal activities three to six months after the surgery (this may not include exercise or other strenuous physical activities).

The Benefits of Revision Knee Surgery

Relief from pain is the main benefit of knee revision surgery. You should be able to walk better and do more of your normal activities. Everyone deserves to live a full and happy life, free from chronic knee pain.

How Soon Can I Drive After Revision Knee Replacement Surgery?

Your ability to drive depends on which knee was replaced. With a left revision knee replacement, you may be able to drive an automatic transmission vehicle in as little as two weeks. If you drive a manual transmission car, it will take a few weeks longer before your left leg is strong enough to operate the clutch. For a right total knee replacement, driving isn’t recommended for at least four weeks or longer.
Chronic knee pain should not stop you from living a full life. Contact my office situated at Vergelegen Mediclinic Somerset West at 021 850 6398 or admin@newlimb.co.za to make an appointment.