Knee Revision Surgery

Knee Revision Surgery

Knee revision surgery, also known as revision knee replacement or revision knee arthroplasty, is a surgical procedure performed whereby a previously implanted artificial knee joint, or prosthesis, is removed and replaced with a fresh prosthesis. Bone grafts may also be used during knee revision surgery.

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When is Revision Knee Surgery is Recommended?

Revision knee arthroplasty may be recommended as a result of certain factors which include:

  • Infection: An artificial joint that contracts an infection may become uncomfortable and stiff. It is possible that the implant will start to separate from the bone. Even if the implant is still securely fastened to the bone, revision surgery is required due to pain, swelling, and reduced mobility.
  • Implant loosening and wear: An implant that was initially fixed firmly either cemented into the bone or press-fit to grow onto the surface of the implant may over time loosen from the underlying bone, making the knee become painful.
  • Instability: A person’s knee may become unstable especially when the ligaments around get damaged or improperly balanced. Any modification to the patient’s current ligaments may prohibit an implant from functioning effectively because the majority of implants are made to work with them.
  • Stiffness: An individual’s range of motion may be restricted by substantial scar tissue or the positioning of the knee’s components, necessitating revision surgery.
  • Fractures: A fractured bone that develops close to the parts of a complete knee replacement is known as a periprosthetic fracture which always occurs as a result of falls, and typically necessitates revision surgery.

Signs of a Knee Replacement Failure

  • Pain
  • Instability
  • Swelling
  • Stiffness
  • Reduced range of motion
  • Excessive fluid in the knee
  • Muscle ache

Possible Complications of Knee Revision Surgery

  • Bone fracture during surgery
  • Bleeding
  • Reduced range of motion or stiffness in the knee
  • Poor wound healing
  • Damage to nerves or blood vessels
  • Blood clots in the legs that may travel to the lungs

Preparation for Knee Revision Surgery

A thorough physical examination is conducted to ensure that the patient is healthy enough to undergo the surgery and complete the recovery process. Imaging tests to find out more about the state of the knee may also be recommended. These include:

  • Blood tests: The doctor may recommend blood tests to check for possible infection
  • X-rays: This may be recommended to check for loosening or change in the position of the components
  • Other imaging tests: If the prosthesis has come free from the bone, a nuclear medicine bone scan could assist identify the problem. Sometimes a computer tomography (CT) or magnetic resonance imaging (MRI) scan will be done to help diagnose the state of the bone and the reason why a person’s knee has failed.

The Procedure

The knee revision surgery is done under spinal or general anesthesia, and the duration is dependent on the extent of the knee joint damage. Majority of revision knee replacement procedures require more time to complete compared to the primary procedure.

The first step of the procedure is to remove the implant. Bone graft might be necessary to fill the gaps if there has been a severe bone loss. There are two types of bone grafts:

  • Autograft: Own bone taken from another area of the body.
  • Allograft: Bone tissue taken from another person, normally obtained from a bone bank.

Metal wedges, wires, or screws may occasionally be utilized to reinforce the bone. The final step involves inserting a specialized revision knee implant. Finally, the doctor will place temporary drains to collect any fluids that may remain following surgery.

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