Everything You Need To Know About Knee Replacement Revision Surgery

Everything You Need To Know About Knee Replacement Revision Surgery

Knee implants have tremendously evolved in the last decade, thanks to advanced on technical and manufacturing techniques. Now the knee implants last for several years. However, there is still a scope left for the prosthetic to wear out or break a few years after implantation. In such cases, a knee replacement revision surgery is warranted.A knee revision surgery involves a partial or complete replacement of the prosthesis that was originally placed during the knee replacement surgery. However, this is not necessary in all cases. For example, some candidates may just require cleaning of the prosthesis and the underlying bone. Whereas in others, the doctors may replace just one or two components during the surgery.

A knee replacement may fail because of many reasons. This may result in extreme pain and swelling. People may feel extreme stiffness and are unable to move around when the implants fail. In such cases, the doctors recommend a second surgery, which is the revision procedure.

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The main aim of both knee replacement and the revision surgery is to relieve pain and inflammation and improve the quality of life. However, the approach to achieve the objective is completely different.

This article explores some of the important things that you may need to know about knee replacement revision surgery.

Criteria for revision knee replacement: Why is it needed?
Revision Knee Replacement

In more than 80 percent of the total knee replacement cases, the knee implants last for at least 15 years. Therefore, they may last for life in the case of the elderly. However, younger candidates are at an increased risk of implant failure. Such individuals may eventually require revision surgery when the implants fail.

There is some amount of bone loss in the total knee replacement procedure. This is the reason why doctors may not be able to use the regular implants that they used in the original procedure. Sometimes, they decide to use special implants with thicker stems that are fitted deep into the bone.

The following are some of the reasons why the doctors may recommend a revision knee replacement:

Infection

Infection is one of the potential complications of knee replacement. This complication arises while you are still at the hospital or may even manifest after discharge. In some patients, an infection occurs after years of the surgery.

Depending on the extent and degree of infection and the type of bacteria present, the doctors may conduct:

  • Debridement: In this case, the metal components are left as is. Only the plastic spacer is replaced and the bacteria is washed off.
  • Staged surgery: In this case, the implant is completely removed. This takes place in two stages. In the first stage, a spacer treated with antibiotics is left in the void after removing the implant for several weeks. After the infection is clear, the surgeons insert a new prosthesis.

Implant Loosening

The prosthesis should remain firmly fixed to the bone. However, over a period of time, the implant may loosen from the bone, which may result in knee pain. The implant may loosen because of several reasons. Excessive weight, wear of the plastic spacer, and high-impact activities are some of the reasons.

Additionally, younger patients may sometimes outlive the life of the implant, which may ultimately loose up after 15 to 20 years. Implant loosening may also occur because of osteolysis, which is an immune response to the bone that surrounds the implant. The specialist conducts a revision surgery in such cases.

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Mechanical Failure

The knee implant may fail when it does not produces results as expected. This may happen because of improper placement of the implant during the surgery and poor choice of implant. It may also occur because of fabrication issues and defect in the implant. The causes can be broadly categorized into surgical, material-related, and idiosyncratic. Surgical issues include issues related to the technique, judgment, and surgery-related infections.

Material-related issues include chemistry, engineering design, and structural metallurgy. Idiosyncratic issues include rejection of implant due to specific conditions such as pain, implant loosening, and sinus tract infection.

The implant may sometimes dislocate from its original location as well. In such cases also, doctors conduct a revision surgery.

Fracture

A fracture may take place in the bone surrounding the prosthesis. These usually result because of trauma, accident, or a fall. In such cases, the doctors conduct a revision surgery. If the bone is completely damaged because of injury or conditions such as osteoporosis, the surgeon may decide to use a bigger revision component. In other cases, the surgeons conduct partial revision.

Instability

The knee may become unstable after getting implants when the ligaments surrounding the joint are no longer healthy. The prosthesis work with the original ligaments. Any damage to these ligaments may eventually affect the prosthesis, increasing the need for revision surgery. The instability may eventually lead to pain and affect the quality of life.

Stiffness

Sometimes, excessive scar tissues may build up around the knee. This may affect the range of motion and thus, affect the ability to perform daily activities. In the case of scar tissue build-up, the doctors may try to manipulate it by bending the knee aggressively. The surgeon advises a revision surgery when the scar tissue is extensive or if the range of motion is not as desired.

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Why is revision surgery tougher than original knee replacement?

Revision surgeries are more susceptible to complications than the original knee replacement surgery. Additionally, the accumulated scar tissue, mechanical breakdown, and trauma can further complicate things.

Revision surgery is more complicated than knee replacement because it involves the complete removal of the original implant. There are huge chances that the implant may have already become attached to the bone by the time a revision surgery is needed. This can further complicate the situation as there may be significant bone loss due to the removal of the implant.

Further, the patient may experience specific symptoms such as:

  • Reduced knee stability and functionality
  • Device failure
  • Bone fracture
  • Increase in pain
  • Implant infection

World-Class Hospitals for Knee Replacement Revision Surgery

One of the largest multi super specialty hospital located in the busy Gurgaon city, Medanta hospital is the brain child of Dr Naresh Trehan, a world renowned cardiovascular and cardiothoracic surgeon. Along with clinical research, education and training, he started the hospital with the aim to bring India to the highest standards of medical care. With total commitment and passion Medanta hospital‘s ethics and operations are guided. The institute has a very large area including a medica... Read More

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Mount Elizabeth Hospital

Singapore,Singapore

  • Joint Commission International, or JCI

Mount Elizabeth Hospital is a multispecialty healthcare facility operated by Parkway Health. The hospital officially started its operations in 1979. Since then, it has been offering quality healthcare services to patients from all walks of life and empowering them with an easy access to high-end and world-class diagnostics, treatment, and rehabilitative services.

The Mount Elizabeth Hospital is accredited by the Joint Commission International (JCI), which is an internationally recogn... Read More

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Located in Dwarka, West Delhi, Venkateshwar Hospital is a leading multi-specialty hospital in the city. The hospital boasts of state of the art infrastructure, Information Technology and dedicated medical staff that is dedicated towards providing world-class treatment to its patients. Situated in the heart of Dwarka, the hospital is reachable from all parts of the city including 10 minutes drive from Domestic and International Airport, 10 minutes drive from Palam Railway Station, 5 minutes f... Read More

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Gleneagles Hospital

Singapore,Singapore

  • Joint Commission International, or JCI

Gleneagles Hospital in Singapore is a multispecialty healthcare facility, located extremely close to the center of the local shopping district. Situated close to the Singapore Botanic Gardens, this hospital is accessed by thousands of patients from within the country and abroad primarily because of its location that can be easily approached by a patient looking forward to high-quality treatment.

Gleneagles Hospital is accredited by Joint Commission International (JCI), which is ... Read More

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Apollo Hospitals

Hyderabad,India

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  • National Accreditation Board for Hospitals & Healthcare Providers (NABH)

Apollo health city is one of the renowned hospitals in Hyderabad astute in covering the total range of treatments starting from addressing the ailments to complete recovery thus proving itself a total health city and not just a medical unit.The centers of excellence include cardiovascular diseases, joint diseases, Cancer, Emergency unit, Neurosciences, Eye and cosmetic surgery unit and renal diseases. They are adept in handling critical conditions and provide quality care to every patient ad... Read More

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Best Doctors to Choose for Knee Replacement Revision Surgery Across the World

Aashish Chaudhry

Orthopedics Specialist - Orthopedic Surgeon, Knee Replacement Surgeon, Hip Replacement Surgeon

Aakash Healthcare Super Speciality Hospital , Delhi,India

16 Years of experience

Qualification and Experience of Dr. Aashish Chaudhry

Dr. Aashish Chaudhry is an acclaimed orthopedic surgeon who has 16 years of experience in treating orthopedic diseases. He has a rich and diverse experience of working with different elite hospitals in India. Dr. Aashish Chaudhry has a track record of successful hip and knee replacement surgeries making him one of the most sought-after orthopedic surgeons in the country. He curren... View bio

Giedrius Kvederas

Orthopedics Specialist - Orthopedic Surgeon, Knee Replacement Surgeon, Hip Replacement Surgeon

Kardiolita Hospital, Vilnius , Vilnius,Lithuania

16 Years of experience

Qualification and Experience

Dr. Giedrius Kvederas is a popular Orthopaedic surgeon in Lithuania. He has over 15 years of experience as an orthopaedic surgeon. His areas of expertise include Hip and knee joint replacement, cancerous diseases in the foot area, ankle joints and bones, various injuries. Dr. Giedrius Kvederas graduated from the Vilnius University, Lithuania. He has trained in many reputed institutes inclu... View bio

Devendra Singh Solanki

Orthopedics Specialist - Orthopedic Surgeon

Artemis Health Institute , Gurgaon,India

21 Years of experience

Qualification and Experience

Dr. Devendra is an Orthopedic Surgeon (Ortho), who holds more than 21 years of experience and currently working with Artemis Hospital, Gurguram. He is considered to be one of the best Orthopaedic doctors in India. Dr. Devendra has completed his MBBS from Sardar Patel Medical College, Bikaner, and MS in Orthopedics from Sawai Man Singh Medical College, Jaipur.

In addition to his qualifications and... View bio

Halil Ibrahim Balci

Orthopedics Specialist - Orthopedic Surgeon

NPISTANBUL Brain Hospital , Istanbul,Turkey

15 Years of experience

Qualification and Experience

Dr. Halil Ibrahim Balci is a world-class Orthopedic surgeon. He is noted for going above and beyond his professional duties to ensure that his patients receive the best possible care. He is well-known for adhering to the profession's principles and delivering the best effective results possible. Dr. Associate Professor Halil Ä°brahim Balci has completed his professional education from Faculty of Medicine... View bio

Dhananjay Gupta

Orthopedics Specialist - Orthopedic Surgeon

Fortis Flt. Lt. Rajan Dhall Hospital , Delhi,India

20 Years of experience

Doctor Profile Overview

One of the finest Orthopedic Surgeon in New Delhi, India, Dr. Dhananjay Gupta has worked with several world class multidisciplinary hospitals over the years. A doctor with outstanding credentials, the medical specialist is known to guarantee efficiency and safety when performing different kinds of procedures as he keeps abreast of latest developments in his specialty. The specialist holds a very degree of exper... View bio

Last modified on at Apr 11, 2022

Guneet Bhatia

Guneet Bhatia is an avid reader, healthcare writer, and is currently Director of Patient Care Department, MediGence. She has also been featured on many prominent Healthcare portals such as IBTimes, HCIT Expert, Clinician Today.

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