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
Indications for Revision Knee Replacement
- 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
What Does the Procedure Entail?
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?
The possible complications after revision knee replacement include:
- Stiffness in the knee
- Formation of blood clots in the leg veins
- Injury to nerves or blood vessels
- Prosthesis failure
- Patella (kneecap) dislocation
- Ligament injuries