Total knee replacement surgery (also known as knee arthroplasty) is one of the most life-changing procedures in orthopedic medicine. For patients with severe knee damage, knee replacement can reduce pain and restore movement to the joint, immensely improving their quality of life. Hundreds of thousands of knee replacements are performed each year in the United States with great success and low complications.
Although surgical materials and techniques grow continually more advanced, knee replacement does not always provide permanent results. A knee replacement may fail for a variety of reasons, causing the knee to become swollen, painful, stiff and unstable. These changes can make it difficult to perform everyday activities once again, and a doctor may recommend a second surgery — revision knee replacement.
A knee implant consists of several components that resemble a natural knee joint in both structure and movement. A metal femoral component attaches to the lower end of the femur (thighbone). A tibial component connects to the upper end of the tibia (shinbone). A patellar component replicates the shape of the patella (kneecap). A plastic spacer fits between the tibial and femoral components to provide a smooth, gliding surface for fluid movement of the joint.
When an artificial knee stops functioning properly, revision surgery may be necessary to replace the defective components. Depending on the extent of the surgery, some or all of the existing replacement components will need to be replaced. The reasons a knee replacement might fail include:
A failed knee implant is usually indicated by pain, swelling and/or a decrease in knee function. Patients who demonstrate these symptoms should see an orthopedic specialist who can identify the cause of the issue and determine whether revision surgery is necessary.
Revision knee replacement is typically a longer, more complex procedure than initial knee replacement. It has a greater risk of complications and requires more extensive planning and surgical expertise to achieve a good result. It is not a procedure to be taken lightly, but when performed on the right candidate by an experienced surgeon, it can be highly rewarding.
Revision knee replacement is generally recommended for patients who are in relatively good health overall, but who are experiencing complications from their original surgery that are preventing them from leading a fulfilling life. Patients who are young when they receive their implant are more likely to require revision surgery in the future, as the artificial joint tends to wear out over time.
Like primary knee replacement surgery, this procedure is performed under general or regional anesthesia. Incisions are made in the same location as the initial surgery to minimize postoperative scarring. Your surgeon will examine the area for infection and signs of damage, and assess the components of the implant to determine which pieces require replacement. The outcome of this assessment will dictate the specific techniques used in your procedure. A revision knee replacement must be tailored precisely to the individual patient’s needs to ensure the highest chance of success.
Although recovery after revision knee replacement is usually slower than recovery after the initial surgery, the care you receive and the postoperative instructions you will be asked to follow are similar. You will be monitored for a day or two in the hospital before returning home to recover in familiar surroundings. Medications will be used to reduce the risk of blood clots and minimize discomfort. Physical therapy exercises should be performed regularly to strengthen and restore range of motion to your knee as it heals. The more closely you adhere to your rehabilitation regimen, the sooner you will be able to resume regular activities.
Knee replacement enables patients to live richer and more active lives free of chronic pain. Over time, however, a knee replacement may require revision surgery to continue providing pain relief, stability and improved range of motion. Most patients who have revision knee replacement surgery experience positive long-term outcomes. To learn more or find out if you are a candidate for this procedure, contact the Orthopaedic Institute of Ohio in Lima today at (419) 222-6622.