Revision Knee Replacement

What is Revision Knee Replacement?

Revision knee replacement surgery involves replacing a part or all 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 may require a second revision surgery.

Indications for Revision Knee Replacement

Revision knee replacement surgery may be advised if you 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

Revision Knee Replacement Procedure

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

The surgery is performed under general anesthesia. Your surgeon makes an incision over your 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 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 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.

Risks and Complications of Revision Knee Replacement

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

Postoperative Care for Revision Knee Replacement

You can walk with crutches or a walker. You will be sent for rehabilitation within a couple of days of surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore range of motion to the knee. Your physical therapist will also provide you with a home exercise program to strengthen the thigh and calf muscles.

If you would like to have additional information on the treatment of various knee conditions or would like to learn more about revision knee replacement, please Contact Christian J. Eccles, M.D., serving the communities of Georgetown, Murrells Inlet, SC.

Why Choose Dr. Christian Eccles for Revision Knee Replacement

Revision knee replacement is a complex operation that calls for careful planning and specialized experience. Here is what you can expect from our team:

• Advanced knee replacement training: Dr. Eccles completed a five-year orthopaedic surgery residency at the University of Louisville and an Adult Reconstruction Fellowship in hip and knee replacement at Indiana University.
• Published work on complications and revision: Dr. Eccles co-authored the AAOS book chapter “Complications of Total Knee Arthroplasty” and a Journal of Arthroplasty study on two-stage revision for knee replacement infection.
• A cause-first approach: We identify why your implant failed, such as wear, loosening, infection, instability, stiffness, or fracture, before deciding which components to replace.
• Planning for bone loss: When bone has been lost around the old implant, Dr. Eccles may use bone graft or metal wedges to rebuild a stable foundation for your new components.
• Two convenient Gilbert offices: We see patients at our North Gilbert and South Gilbert offices, close to home for families in Gilbert, Queen Creek, Chandler, and Mesa.

Revision Knee Replacement FAQs

Why might I need revision knee replacement?

Common reasons include a worn or loose implant, infection, instability, stiffness, bone loss around the implant, or a fracture. Increasing pain or a knee that gives way are signs worth having checked.

Is revision surgery more involved than my first knee replacement?

Yes. Old components must be removed and lost bone may need to be rebuilt, so the operation is more complex. We will explain what to expect for your specific situation.

Will I stay in the hospital?

Revision procedures typically require at least one overnight stay. They are generally not done as same-day surgery.

What is recovery like?

You will walk with crutches or a walker at first and begin physical therapy within a couple of days. Your therapist will give you a home exercise program to strengthen your leg and restore motion.