Revision Joint Replacement

Revision hip or knee replacement is a complex surgical procedure performed in individuals who already had knee or hip replacement surgery but had certain complications that led to failure of the previous surgery. Revision joint replacement is a more complicated surgery when compared to the initial joint replacement surgery. Joint revision surgery requires extensive pre-operative planning, specialized implants and tools, and mastery of difficult surgical techniques to accomplish good results.

Symptoms

The most common reasons people for knee revision are:

  • Infection
  • Instability
  • Stiffness
  • Wear and tear

Causes & Effects

  • Implant Loosening and Wear
  • Infection
  • Instability
  • Stiffness
  • Fractures

Revision Joint Replacement Treatments of Dr. Raviprakash

  • activity level before surgery
  • overall general health
  • severity and duration of physical impairment before surgery
  • type of surgery (i.e., cemented, non-cemented,minimally invasive)
  • attitude toward recovery and motivation
1.What causes a knee replacement implant to fail?

The primary causes of knee implant failure are wear and loosening, infection, instability, leg fractures, or stiffness.

Age, activity level, surgical history and a person’s weight can contribute to implant failure. Younger, active patients, people who are obese, and those who have had prior knee surgeries all have a higher increased risk of a failed implant.

The most common symptoms of a failed knee implant are pain, decrease in joint function, knee instability, and swelling or stiffness in the knee joint.

Revision total knee replacement is the replacement of a failed total knee prosthesis with a new prosthesis. In simple terms, it is the replacement of a knee replacement (or a "second knee replacement").

When the decision for revision knee replacement is made, the surgeon will do a thorough clinical exam and order X-rays and laboratory tests. If infection is suspected, aspiration of the knee (joint fluid removed with a needle) may be required. The aspirated fluid will then be sent to a laboratory for analysis to identify the specific type of infection.

First, the old implant is removed and, if needed, bone grafts are used to fill any voids where bone has deteriorated. Then the new prosthesis is placed.

Home Planning

Because your mobility will be limited after surgery, you may need help for several weeks with tasks like cooking, shopping, bathing, and doing laundry if you live alone.

Your doctor's office, a social worker, or a discharge planner at the hospital can help you make advance arrangements to have someone assist you at home. Depending on your condition, you may need to stay at a nursing facility or rehabilitation center for some time after you leave the hospital. Your healthcare team can also help you arrange for a short stay in an extended care facility during your recovery, if needed.