Knee Revision
If you’ve had a knee replacement and you develop problems with it, knee revision surgery can help relieve pain and improve function
If you’ve had total joint knee replacement, you have probably benefitted from the procedure that has a record of success in most cases.
However, over time some people develop problems that can cause pain, swelling and difficulty with function. If this occurs, knee revision surgery may be a recommended option for you.
According to the American Academy of Orthopaedic Surgeons (AAOS) knee revision surgery is more complex than total knee replacement surgery. This is because where in your original surgery, your joint was replaced with an implant, when the implant itself develops problems, your surgeon is actually going in and repairing that original implant. Or, it may need to be removed and a new joint put in, or parts of it replaced.
Why Is Revision Surgery Needed?
There are several reasons you may find yourself with pain, swelling or stiffness in your joint replacement knee:
- The implant has loosened causing it to no longer function properly, which can cause pain
- Parts of the implant have broken off and are irritating the surrounding tissue and bone When this happens your immune system will attack this irritant and even your own healthy bone. This condition the AAOS notes is called osteolysis.
- Younger patients run the risk of outliving their knee replacement and just the aging and wear and tear of the implant requires the revision.
- Infection may have occurred after the original surgery. Your surgeon will either treat the infection by replacing some of the parts of the joint or remove and replace it completely. This is dependent on how severe the infection is.
- Your joint may be unstable, especially if the ligaments around the replacement have changed. Bracing or physical therapy may first be tried to stabilize your knee. If that doesn’t work, then revision surgery may be needed.
- Your range of motion may not be good enough to keep up with your daily activities and your joint may be stiff. While your physician may try to work out the stiffness, but if that doesn’t work, revision surgery may be recommended.
- You may have a fracture around your replaced knee joint. This again can cause instability and surgery to regain stability may be recommended.
Knee Revision Surgery
Your surgery will be done under anesthesia. You may be given general anesthesia, where you are completely asleep for the procedure or the area of the knee may be numbed (nerve block anesthesia) and you will be awake, but you will not feel anything. You and your team will determine the type of anesthesia that is best for your individual condition.
The surgery can take anywhere from 2 -3 hours, and your incision may be longer than the original. During the procedure your original implant will be inspected and as much of your bone preserved as possible. If there has been much bone damage or loss, other implant components will be added to help regain stability.
Your revision implant will be constructed, surrounding tissues repaired and your surgeon with ensure the joint in functioning before you are moved to recovery.
What to Expect with Knee Revision Surgery
According to the American Academy of Orthopaedic Surgeons (AAOS) knee revision surgery is more complex than total knee replacement surgery. This is because where in your original surgery, your joint was replaced with an implant, when the implant itself develops problems, your surgeon is actually going in and repairing that original implant. Or, it may need to be removed and a new joint put in, or parts of it replaced.
Why Is Revision Surgery Needed?
There are several reasons you may find yourself with pain, swelling or stiffness in your joint replacement knee:
- The implant has loosened causing it to no longer function properly, which can cause pain
- Parts of the implant have broken off and are irritating the surrounding tissue and bone When this happens your immune system will attack this irritant and even your own healthy bone. This condition the AAOS notes is called osteolysis.
- Younger patients run the risk of outliving their knee replacement and just the aging and wear and tear of the implant requires the revision.
- Infection may have occurred after the original surgery. Your surgeon will either treat the infection by replacing some of the parts of the joint or remove and replace it completely. This is dependent on how severe the infection is.
- Your joint may be unstable, especially if the ligaments around the replacement have changed. Bracing or physical therapy may first be tried to stabilize your knee. If that doesn’t work, then revision surgery may be needed.
- Your range of motion may not be good enough to keep up with your daily activities and your joint may be stiff. While your physician may try to work out the stiffness, but if that doesn’t work, revision surgery may be recommended.
- You may have a fracture around your replaced knee joint. This again can cause instability and surgery to regain stability may be recommended.
Knee Revision Surgery
Your surgery will be done under anesthesia. You may be given general anesthesia, where you are completely asleep for the procedure or the area of the knee may be numbed (nerve block anesthesia) and you will be awake, but you will not feel anything. You and your team will determine the type of anesthesia that is best for your individual condition.
The surgery can take anywhere from 2 -3 hours, and your incision may be longer than the original. During the procedure your original implant will be inspected and as much of your bone preserved as possible. If there has been much bone damage or loss, other implant components will be added to help regain stability.
Your revision implant will be constructed, surrounding tissues repaired and your surgeon with ensure the joint in functioning before you are moved to recovery.
If you are having problems with your knee after total joint knee replacement your physician will likely order x-rays and other imaging tests to determine the exact cause. Lab tests might also be ordered if infection is suspected.
Preparing for Knee Revision Surgery
If you are having problems with your knee after total joint knee replacement your physician will likely order x-rays and other imaging tests to determine the exact cause. Lab tests might also be ordered if infection is suspected.
You’ll may have some pain after your surgery and your team will help you manage it with medication. You’ll also be given exercises to strengthen your leg muscles and help with range of motion.
Preventing blood clots and infection is also key and your ortho team will make sure preventive measures are taken to lessen these possibilities. All surgery carries some risks and you will be discharged with instructions of what to watch for as you are recovering.
After Discharge
As with any surgery where your mobility might be affected, ensuring you have help at home for your daily tasks is key to your successful recovery. A stay at a rehabilitation center may be recommended if needed.
After Your Knee Revision Surgery
You’ll may have some pain after your surgery and your team will help you manage it with medication. You’ll also be given exercises to strengthen your leg muscles and help with range of motion.
Preventing blood clots and infection is also key and your ortho team will make sure preventive measures are taken to lessen these possibilities. All surgery carries some risks and you will be discharged with instructions of what to watch for as you are recovering.
After Discharge
As with any surgery where your mobility might be affected, ensuring you have help at home for your daily tasks is key to your successful recovery. A stay at a rehabilitation center may be recommended if needed.
You want to make sure you are selecting the best option for your knee condition. Be sure to write down and bring your questions to your consultation to ensure that you understand all your options and your surgery. Here are some to get you started:
- Why is revision surgery needed?
- Can physical therapy alone help my condition?
- What is the success rate of knee revision surgery?
- What can I expect after my surgery? Will my mobility be improved?
- Will the surgery get me out of pain?
- What will my recovery time be?
- What activities can I do? What should I avoid doing?
Questions to Ask Your Physician About Knee Revision Surgery
You want to make sure you are selecting the best option for your knee condition. Be sure to write down and bring your questions to your consultation to ensure that you understand all your options and your surgery. Here are some to get you started:
- Why is revision surgery needed?
- Can physical therapy alone help my condition?
- What is the success rate of knee revision surgery?
- What can I expect after my surgery? Will my mobility be improved?
- Will the surgery get me out of pain?
- What will my recovery time be?
- What activities can I do? What should I avoid doing?
