Revision Knee Replacement
Knee replacements usually last at least 10-15 years. If you have a replacement earlier in life or suffer from complications after the initial surgery, you may eventually need a revision knee replacement.
Revision knee replacement is a more complex procedure than a partial or total knee replacement. The aim for revision surgery is to relieve symptoms caused by the failing implant, or by a worsening of arthritis after a partial knee replacement. Revision knee replacement surgery involves removing and replacing some or all of the components of the initial knee replacement.
Dr Jason Ward provides expert assessment and consultation across Adelaide and South Australia for all types of knee replacements procedures . Contact his rooms to book an appointment.
Preparing for a knee replacement
Revision knee replacement is needed when an existing knee replacement wears out or fails. Signs of a failing knee replacement may include:
Increasing knee pain
This may be accompanied by swelling, and may be generalised or localised to one part of the knee or leg.
Stiffness in the joint
It may feel difficult to bend or straighten the knee to its full range of motion.
Joint infection
This is a rare but serious complication which can be limb-threatening. Multiple procedures may be needed to manage the infection and retain knee function.
Feelings of instability
The knee may buckle and give way while walking, or feel as though it might.
Recent trauma
A fracture or other damage to the leg may damage the implant and existing bone.
How does revision knee replacement work?
Similar to regular knee replacement, revision knee replacement involves removing the non-functional prosthetic knee joint and replacing it with a new one. Revision knee replacements are made from similar materials to knee replacements, mainly made from metal alloy and plastic inserts.
In the operating theatre, Dr Jason Ward removes the old prosthesis, any bone cement used to hold it in place, and any any diseased sections of bone. The old prosthesis is then replaced with a specialised implant for the revision knee surgery. This usually requires stemmed prostheses which allow a better fit into the femur (thigh) and tibia (shin) bones, to give better stability.
Occasionally, significant bone loss around the failed joint replacement may require ‘augments’ made of either specialised metal alloy or bone graft. These augments will help provide extra stability for the prosthesis and your knee.
Revision knee replacement surgery is often more complex and takes longer than the initial knee replacement procedure. Dr Jason Ward has undertaken extra training and can offer the latest technologies in this often complex field of surgery.
What are the risks of revision knee replacement surgery?
Like any surgical procedure, revision knee replacement carries surgical risks with it. These risks can include infection, bleeding, blood clotting (DVT), poor wound healing, damage to blood vessels and nerves, ongoing pain, scarring and further need for surgery. Risks specific to revision knee replacement include:
- Bone fracture during or following surgery
- Persistent stiffness with reduced movement of the knee
- Failure of bone to fuse to the implant
Recovering from revision knee replacement
After revision knee replacement, patients recover in hospital for several days. During this time, you will receive pain medication and antibiotics and you will be supported by a team lead by Dr Ward and the nursing staff. A sterile dressing will cover the surgical site and a drain may be placed in the knee to remove excess fluid.
Physiotherapy begins early, generally within 24 hours of your procedure. The team will assist you to stand and perform simple exercises. Usually the joint is stable immediately after the procedure, however weakened muscles will require time to return to full strength.
When Dr Jason Ward is confident in your recovery and your independence with mobility, you will be discharged with post-operative instructions and oral medication. Dr Ward will continue to manage your care through his clinic in the following weeks.