Revision Of Knee Replacement

Revision surgery of the knee is a follow up procedure which is undertaken after replacement surgery stops yielding benefits. Modern implants used in knee replacement are robust and have a long life, but they too are subject to wear and tear. The revision surgery involves the replacement of the older prosthetic device with a newer one. The replacement surgery benefits last for 15 to 20 years, but other causes such as overweight, sporting activities, running, etc., may cause the implant to fail.

Revision Surgery Complexity Compared To Total Knee Replacement Surgery

The revision surgery should not be taken casually by the patients. It is a more complicated surgery than the initial or primary replacement surgery. It has the same risks usually associated with knee replacement. However, Statistics show that a large number of patients sign up for the revision surgery within two years of the initial knee replacement surgery. The revision knee replacement does not provide the same life span as the initial replacement surgery of the knee.

Reasons for Complexity Of Revision Surgery

  • The original implant has to be removed with greater alacrity to avoid bone damage.
  • Removal of the prosthesis leads to less of the bone remaining inside.
  • Some revision surgeries may even require a bone graft to support the new prosthesis.
  • Additional preoperative planning, specialised tools, and surgical skill are required.
  • The surgery itself takes a longer amount of time as compared to standard surgeries.

 

Two Types of Revisions –

Short term revision

Short term revision is necessitated due to the following reasons –

  • Infection occurring within days or weeks of the surgery.
  • Failure of the initial procedure causing the implant to come loose.
  • Mechanical failure of the implant or prosthetic device.

 

Long term revision

Long term revision is necessitated due to the following reasons –

  • Excessive pain in the knee and joints
  • Stiffness in the joints while moving, running, walking, etc.,
  • Loosening due to wear of mechanical components
  • Dislocation of the new implant

 

Post-Revision Surgery Complications

  • Infection in the new prosthetic implant or device.
  • Loosening of the implant which usually occurs in overweight patients.
  • Increase in the risk of dislocation of the new implant.
  • Bone related problems including fracture, loss of bone tissue, and formation of heterotopic bone at the lower end of the femur.

 

Recovery and Rehabilitation Process

  • The patient who undergoes the revision of knee has to go through the recovery process identical to the first knee replacement.
  • Administration of medication suggested by the expert doctors is done in a careful manner.
  • Physical therapy is provided with the help of cooperative and trained professionals.
  • Parallel bars, walkers, canes, etc., are used for walking practise.
  • Blood thinners are administered so as to avoid clotting.
  • Rehabilitation is successful if the patient is able to stand and walk as quickly as possible.
  • The bone growth and implant bonding are successful only if there is sufficient pressure, compression, and resistance.
  • The positive attitude and cooperation of the patient also plays an important role.