Revision Knee Replacement

What Is Revision Knee Replacement ?

Revision Knee Surgery refers to the procedure of revising part or all of a previous knee replacement. This may involve minor adjustments or extensive operations to replace significant amounts of bone. In a standard knee replacement surgery, the plastic inserts are placed between the ends of the femur (thigh bone) and tibia (shin bone), along with the knee cap (patella).

Indications For Revision Knee Replacement

The primary indication for revision knee surgery is pain, although the underlying cause may not always be evident. In cases where the source of the pain is unclear, the surgery may not be as successful

Other indications for revision knee surgery include:

Polyethylene wear: This is a simpler type of revision where only the plastic insert needs to be replaced.

• Instability: This occurs when the knee is unstable and may feel unsafe or give way when walking.
• Loosening of any of the components (femoral, tibial or patella): This is typically accompanied by pain, although it may also be asymptomatic. It is important to have regular follow-ups to detect any changes on X-ray that could indicate the need for revision surgery, even in the absence of symptoms. Infection: This often presents with pain, swelling, or fever. Osteolysis (bone loss): This can occur when particles are released into the knee joint, resulting in the destruction of bone.
• Stiffness: Revision surgery may not always improve stiffness, but it can be beneficial in specific cases.

Revision Knee Replacement Procedure

The surgical procedure begins with the patient being placed under either general or spinal anaesthesia in a sterile operating room. The previous knee replacement is removed, and the bone ends of the femur and tibia are prepared using saws and burrs to remove any damaged or worn-out components.

Once the old components are removed, trial components are inserted to ensure proper fitting before the real femoral and tibial components are put into place, either with or without cement. In some cases, additional pieces of metal or bone may be added to address any bone loss or instability.

Following the procedure, the knee is closed carefully, drains are usually inserted, and the area is dressed and bandaged. Rehabilitation and physical therapy are crucial for a successful outcome after revision knee replacement surgery.