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Revision Knee Replacement

Expert surgical and medical interventions delivered with compassionate, patient-first care to help you regain your health and quality of life.

Overview

While primary total knee replacements are incredibly successful, the artificial implants do not last forever. Over 15 to 20 years, they can slowly wear out. In other cases, complications like an infection or a fracture around the implant can cause it to fail early, resulting in a return of severe knee pain, instability, and swelling.

**Revision Knee Replacement** is a highly complex, specialized surgery performed to remove the old, failing artificial knee joint and replace it with new, specialized revision components.

Because removing the old implant often removes some bone with it, revision surgery requires a higher level of surgical expertise. Our senior joint replacement team at Prakash Hospital has extensive experience in managing complex revision cases, utilizing bone grafts, metal augments, and stemmed implants to firmly secure the new joint and relieve your pain.

Why is it Done?

A revision surgery is required when the original knee replacement has failed. The most common reasons include:
  • Aseptic Loosening: The most common cause. Over years of use, the bond between the implant and your natural bone breaks down, causing the implant to rattle loose and cause pain.
  • Infection: A bacterial infection around the artificial joint is a serious emergency that often requires the implant to be entirely removed, the infection cleared with antibiotics, and a new implant placed later.
  • Instability: If the ligaments surrounding the knee have stretched or torn over time, the knee may feel like it is constantly giving way.
  • Periprosthetic Fracture: A severe fall causing the bone around the implant to break, destabilizing the entire joint.

What to Expect

Before the Surgery: Extensive planning is required. We will perform specific blood tests and joint fluid aspirations to rule out infection. Advanced CT scans help the surgeon assess exactly how much bone loss has occurred.

During the Procedure: Revision surgery takes much longer than a primary replacement, often 2 to 4 hours. The surgeon carefully removes the old implants and any scar tissue. Because there is less natural bone left, the new revision implants have long metal stems that go deep into the thigh and shin bones for support. Metal blocks or bone grafts are used to fill in areas where bone is missing.

After the Surgery: Your hospital stay will be longer, typically 4 to 6 days. The post-operative pain management protocols are more intensive, as the surgery is more extensive.

Risks & Benefits

The Benefits:

The goal of revision surgery is to relieve the severe pain caused by the failed implant, restore functional stability to the leg, and allow you to walk comfortably again.

Understanding the Risks:

Revision surgery carries higher risks than primary surgery, including a higher chance of infection, bleeding, blood clots, and stiffness. The range of motion after a revision is often slightly less than after a primary knee replacement.

Recovery Profile

Recovery is more demanding and takes longer than your first knee replacement.

Depending on how the new implant was secured (especially if large bone grafts were used), the surgeon may restrict you from putting full weight on the leg for several weeks, requiring a walker.

Physical therapy will be challenging but is absolutely necessary to prevent scar tissue formation. It may take 6 to 12 months to realize the full functional benefit of the revision surgery.

Frequently Asked Questions

Is revision surgery more painful than the first knee replacement?

Because it is a longer, more complex surgery, it can be more painful initially. However, our advanced multi-modal pain management protocols ensure that your pain is aggressively controlled throughout your recovery.

Can an infected knee replacement be fixed in one surgery?

Rarely. If the implant is infected, standard protocol is a 'two-stage' revision. Surgery 1 removes the implant and inserts an antibiotic spacer. You receive IV antibiotics for 6 weeks. Surgery 2 is then performed to put the new permanent implants in once the infection is totally gone.
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Prakash Hospital Pvt. Ltd. is a 100 bedded NABH NABL accredited multispecialty hospital along with a center of trauma and orthopedics. We are in the service of society since 2001.

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