Knee revision replacement surgery

What is a revision knee replacement?

A revision knee replacement involves removing the previous prosthesis and replacing it with a new one.

Primary total knee replacement surgery offers a good result for patients, but it’s likely that revision knee replacement surgery will be required around 15-20 years after your first knee replacement.

Why would I need a revision knee replacement?

Over time, it’s possible that your first knee replacement may wear out or break. This is likely to happen sooner if you are overweight or play high-impact sports. You may also need revision surgery if your levels of pain are increasing and your knee functionality is deteriorating.

The objectives of your first surgery and your revision surgery are still the same – to offer pain relief and to improve the function and stability of your knee. However, there are some differences with a revision surgery. The procedure is more complex than the original knee replacement as it involves removing the old knee replacement components and implanting new ones.

There are various reasons why a revision knee replacement is needed. 

Possible reasons include:

• Infection
• Wearing of plastic component
• Implant failure causing the prostheses to loosen - not related to bacterial infection
• Instability
• On-going severe pain

What will happen during my revision knee replacement surgery?

If your X-rays and bone scans show that a revision is needed, then your consultant surgeon may advise for you to have the procedure.

If the revision is due to an infection, the surgeon will have to perform the operation in two stages. The first stage involves taking out the previous components and inserting some bone cement with antibiotics into the knee. The second stage is carried out after 6 to 8 weeks if there is no more infection. Your surgeon will then remove the bone cement and place the new knee implants.

If there was no infection present, the entire surgery can be done in one stage. The implant will be removed, the joint washed out and the new implant inserted. This procedure can also be performed with the help of computer navigation to align the limb properly.

What are the potential complications or risks from this surgery?

Although unlikely, any surgery has some associated risks. As a revision knee replacement is more complex, there is a greater risk of complications. However, your consultant surgeon will discuss any potential risks with you before you have surgery.

Possible complications from a revision knee replacement include:

• Reduced range of motion in the knee
• Knee pain and stiffness
• Bleeding
• Wound infection
• Blood clots
• Nerve damage

Will I be in pain after surgery?

As with any surgery, you will experience some pain afterwards. However, this is completely normal and is part of your recovery.

If you experience any discomfort following your operation, this can be managed with prescribed pain medication which will also help you get the most out of your physiotherapy sessions. However, if you feel you aren’t receiving enough pain relief, your consultant or a member of your healthcare team should be made aware.

How long does it take to recover from a revision knee replacement?

Recovering from revision surgery may take longer than your first surgery.

Following the operation, you will need to use walking aids for the first six weeks. It’s important to remember that it may take months before you can walk without pain.

Physiotherapy will also be an important part of your recovery. It will help you regain strength, improve your mobility and help you get back to normal activities as soon as possible.

If you have any concerns during your recovery, then it’s best to seek advice from your healthcare team.