A knee replacement typically lasts for about 20 years for most patients. However, in some cases, a second surgery called revision knee arthroplasty may be required. This procedure is necessary when the initial implant fails, to prevent permanent damage to the joint and surrounding tissues.
Request an AppointmentReasons for Revision Knee Arthroplasty
While most patients experience a smooth recovery after knee replacement surgery, some may encounter complications that require revision surgery. The reasons for implant failure can vary, and the most common causes include:
Overuse
With more seniors living longer and remaining active, and younger individuals undergoing knee replacements at an earlier age due to more energetic lifestyles, implants may wear out faster. This increased use can lead to the need for revision surgery as the implant becomes worn and less effective.
Instability
Though implants are firmly secured during surgery, they can sometimes loosen due to friction within the joint. This issue may also arise following an injury, such as a fracture. The risk of knee instability is higher if the patient becomes obese or if excess weight puts more strain on the joint.
Infection
Though rare, infections following knee replacement surgery can occur. If an infection develops in the knee joint, even if the implant is still securely attached, a revision may be required to treat the infection and preserve the joint’s function.
Dislocation
Though infrequent, it is possible for the implant to shift out of its proper position. If this happens repeatedly, it may require revision surgery to correct the alignment and restore stability to the knee.
Inflammation
Occasionally, patients who have undergone knee replacement surgery develop an inflammatory response known as osteolysis, which can occur around the prosthesis. In this condition, wear and tear causes small particles of plastic to break off and trigger an inflammatory reaction as the body absorbs them. This is often aggravated by an uneven walking gait, leading to pain and instability.
The Revision Knee Arthroplasty Procedure
The procedure for revision knee arthroplasty depends on the reason for implant failure and how much time has passed since the initial surgery. In some cases, the incision for the revision may be made at the same site as the first surgery, while in others, a different approach may be needed.
In many cases, the revision surgery will closely resemble the original knee replacement procedure. However, if there is significant damage to the bone or surrounding tissue, additional reconstruction may be required using bone grafts or metal plates and screws to secure the new implant. Once the components are in place and fixed with cement, the surgeon will drain any excess fluid from the joint and close the incision with sutures.
Recovery from Revision Knee Arthroplasty
After undergoing revision knee arthroplasty, patients will need to limit their activities for 6 to 12 weeks. During this time, they may require braces for added stability or assistive devices like crutches or walkers to reduce weight-bearing and improve mobility.
Physical therapy plays a vital role in recovery, and patients will typically undergo rehabilitation for 2 to 3 months to regain strength and function in the knee. This helps ensure the best possible outcome and long-term joint health.