Surgical Information – Procedures

Revision Total Knee Replacement

What is revision total knee replacement?

Revision total knee replacement is a surgical procedure to remove the original prosthesis (implant) from a total knee replacement and replace it with a new one. Revision total knee replacement is a complex procedure that requires extensive pre-operative planning, specialized implants and tools, longer operating times and mastery of difficult surgical techniques to achieve a good result.

The goal of revision total knee replacement is to relieve pain and improve function in your knee. The most common reasons for the procedure include:

  • Failure of the original prosthesis due to loosening or significant wear and tear
  • Infection
  • Ligament instability
  • Excessive scar tissue around the knee joint
  • A fracture near the prosthesis (known as a periprosthetic fracture)

Some revision surgeries replace only part of the prosthesis. Others replace the entire device. In these cases, the surgeon must rebuild the bone around the knee with a bone graft. A specially designed implant, different from the type used in a standard total knee replacement, may be required with longer, thicker stems that fit deeper inside the bone for extra support.

Anatomy

The knee is the largest joint in the body and one of the most complex. It is made up of the femur, tibia and patella (kneecap). Articular cartilage covers the ends of the bones and allows them to glide smoothly over one another. Osteoarthritis and rheumatoid arthritis cause the surface layer of cartilage to wear away. Without this cushioning effect, the bones of the knee joint rub together. The knee can't move easily and becomes stiff, swollen and painful.

When is surgery recommended?

If you have had total knee replacement and develop knee pain that limits your everyday activities, you should consult an orthopedic surgeon trained in revision total knee replacement surgery techniques. After evaluating your condition, the physician may recommend a revision procedure.

What is the recovery time?

Recovery from revision total knee replacement is similar to that of total knee replacement, but may take a bit longer depending on the extent of the surgery and your overall health. Sometimes, your surgeon may recommend limiting the weight you put on the operative leg while the body grows onto the components or a fracture heals. Patients typically spend a night or two in the hospital and begin post-operative physical therapy to restore range of motion, flexibility and strength. Return to work and daily activities varies by patient and demand.