Revision Knee Replacement & Arthroplasty Surgery

Revision Knee Surgery

Revision knee surgery generally involves removing some or all of the old components of your knee replacement, followed by re-implantation of new implants.

Careful pre-operative planning is performed in each individual case and the type of new knee replacement is determined accordingly.

Risks and Benefits

Overall, revision knee replacement is a reasonably successful operation in modern-day surgery. In my practice, the success rate of a revision knee replacement is 85% or higher. This does vary on a case-by-case basis and I will be happy to discuss this with you during the consultation.

Risks of revision knee surgery are similar to that of total knee replacement but are deemed to be slightly higher. These include infection (around 2-3%), bleeding, DVT (clots in your leg), PE (clots in your lung), stiffness, loosening, wear, persistent pain (around 1%), medical and anesthetic complications. Precautions are taken in order to minimize all the above risks e.g. use of antibiotic prophylaxis and specialized laminar airflow theatres to minimize the risk of infection, use of blood-thinning medications, and mechanical methods to reduce the risk of clots, etc. Post-operative exercises are extremely important to decrease the risk of post-operative stiffness.

Rehabilitation and Recovery

You are generally admitted to the hospital on the day of surgery. The average length of stay in the hospital is 3-4 days. During the hospital stay, a multi-disciplinary team including an orthopaedic team, ward doctor, nursing staff, physiotherapist, and occupational therapist, treats you. Once you and the team are happy with the progress, you are discharged from the hospital.

Post-operative mobilization includes the use of walking aids like walkers or crutches, to begin with. You can subsequently use the walking stick/s until independent mobility can be achieved.

You can expect some swelling and redness around the wound and of the lower leg for a few weeks. Generally, by 12 weeks, functional recovery can be expected in most patients. Most patients can expect to drive around 6 to 8 weeks mark.

• Revision Arthroplasty of the Knee

Frequently Asked Questions

Q1. What is a revision knee replacement surgery?
A revision knee replacement is a complex surgical procedure to replace a previous artificial knee joint (prosthesis) that is no longer functioning correctly.

Q2. What is the recovery time for knee replacement revision surgery?
Recovery time for knee replacement revision surgery typically takes six months to a year for near-normal function, though the knee may continue to improve for up to two years.

Q3. How long does knee arthroplasty last?
A total knee arthroplasty generally lasts for 15-20 years, with many lasting for 25 years or more, and even up to 30 years for some patients. However, partial knee arthroplasties tend to have a shorter lifespan.

Q4. How many times can a knee revision be done?
There isn’t a definitive number for how many knee revisions a person can have, as each case is different and depends on individual health, activity levels, and the specific reason for revision.

Q5. What is the maximum age for knee replacement surgery?
There is no maximum age for knee replacement surgery; candidacy is based on individual health, functional limitations, and the severity of pain and disability, not age alone.

Q6. What is the cost of revision knee replacement?
In the UK, the cost of private knee revision surgery can range from approximately £17,500 to over £23,000, though prices vary based on the hospital, surgeon, complexity of the case, and implant type.

Q7. What are the problems with revision surgery?
Problems with revision surgery include increased surgical complexity, such as dealing with scar tissue, poorer bone quality, and potential bone grafting needs, leading to longer operating times, greater blood loss, and more challenging recovery compared to a first-time surgery.

Q8. What is the most common reason for revision arthroplasty?
The most common reason for revision arthroplasty is infection, with aseptic loosening and instability often being the next most frequent causes, though specific reasons can vary slightly by the type of joint and study.

Q9. What is the first stage of revision surgery?
The first stage of two-stage revision surgery involves removing the existing artificial joint, thoroughly cleaning and debriding the infected area, and placing a temporary antibiotic-loaded spacer.

Q10. What is the most common reason for knee revision?
The most common reason for knee revision is aseptic loosening, where the implant becomes loose without infection.