Dr. Hemant Sharma
FRCS (England) MRCS (England) DNB
Specialist in Revision Lower Limb ArthroPlasty
Complex Hip, Knee and Sports Injury
Important facts about revision total knee replacement surgery Revision surgery is a serious procedure that should not be taken lightly. It’s more difficult than a primary (or first) total knee replacement (TKR) and comes with many of the same dangers. Despite this, more than 22,000 knee revision procedures are projected to be performed in the United States each year. Within two years following the first knee replacement, more than half of these surgeries are performed.
Why is revision surgery more difficult than the first procedure?
It’s crucial to keep in mind that a revision knee replacement will not last as long as the original (around 10 years). Decreased performance is the result of accumulated damage, scar tissue, and component mechanical degradation. Complications are more likely to occur during revisions. Because the surgeon must remove the initial implant, which would have grown into the existing bone, a revision technique is often more difficult than a standard knee replacement surgery.
Furthermore, less bone remains when the knee replacement revision surgeon takes away the prosthetic. A bone graft, which involves transferring a fragment of bone from another region of the body or from a donor, may be essential to sustain the new prosthesis in some cases. A bone graft provides additional support and promotes the formation of new bone. The procedure, on the other hand, necessitates more preoperative planning, specific tools, and surgical experience. The procedure is more time consuming than a primary knee replacement.
• If revision surgery is required, you will have certain symptoms. The following are signs of excessive wear or failure:
• Increased discomfort or infection due to decreased stability or function in the knee (that primarily takes place immediately after the basic process)
• Fracture in the bone or a complete breakdown of the device
Bits and parts of the prosthetic unit may fall off in other circumstances, causing microscopic particles to collect around the joint.
Why there is a need for revision surgery?
Infection, mechanical failure or loosening of implant due to some kind of faulty operation leads to short-term revisions. In most cases, an infection develops within weeks or even days of surgery. Infection, on the other hand, might arise many years following surgery. Infection after a knee replacement surgeon can lead to serious complications. Bacteria that accumulate around the incision or within the implant cause it. Contaminated instruments, personnel, and other materials in the operating area can all spread infection.
Infection is rare in the surgery room due to the extraordinary measures used. Nevertheless, if an infection occurs, it can result in an accumulation of fluids and the need for a revision.
Contact your surgeon right away if you feel any unusual swelling, discomfort, or fluid leakage. You’ll be invited to undergo an assessment and examination if your surgeon senses an issue with your existing prosthetic knee. This may include X-rays as well as other imaging diagnostics like a CT or MRI scan. The latter can reveal crucial information regarding bone loss and help you decide whether you’re a good candidate for a revision.
When fluid builds up around an artificial knee, the fluid is routinely removed using an aspiration surgery. The fluid is sent to a lab for analysis to establish the type of infection and whether a revision operation or additional treatment measures are necessary.