Revision Total Knee replacement

Although the failure rate per annum is low, knee replacements do not last forever. There are two main reasons to revise a knee replacement. The first, and most common, is infection, which can cause early loosening of the TKR. This usually occurs in the first couple of years after the initial operation and is often due to an infection at the time of the initial surgery.

The other main reason for TKR failure is the non-infective loosening of the knee replacement. This generally occurs several years after initial operation and can be due to a mechanical failure of the knee replacement.

In some early knee replacement designs, the plastic part of the tibial component became worn and fragmented after 8-10 years. Newer designs have considerably better durability but, eventually, even these will show signs of wear.

What happens during Surgery?

The surgery involves removing the old knee replacement whilst leaving as much of the original bone as possible. There can be a considerable amount of bone loss, particularly if the old knee replacement has been infected. If this is the case, it may be necessary to complete the procedure with two operations. In the case of infection, the old knee replacement is removed and the wound is closed. Then antibiotics are given and the infection eradicated over 4-6 weeks. The second stage involves the insertion of the new knee replacement. This technique minimises the risk of any further infection.

Essentially, the revision TKR is similar to the Primary TKR. The revision, however, needs to be able to deal with the probable loss of bone incurred during the removal of the original knee replacement. This is achieved by using metal blocks and stems, which attach to the main components and compensate for any loss of bone.

After a Revision Total Knee Replacement

The day after the operation your exercise regime begins. With the aid of a physiotherapist you will get out of bed and begin to exercise your new knee replacement. With perseverance, you should be able to climb stairs by day 5 or 6 and go home the following day.

You will need to continue attending physiotherapy as an outpatient. This can be done closer to your home with one of our recommended group of physiotherapists.

For most people it will take around 6-8 weeks to be walking reasonably. After six months you should be able to walk well without pain, climb stairs (leading with your operated leg) and be capable of a range of movement with your new knee from 0 degrees to at least 90 degrees.

What can I do with my new knee?

The outcome of a revision TKR is generally not as good as that of a primary knee replacement. The revision knee replacement will, however, give excellent pain relief and as good a range of movement as a primary TKR. You will be able to walk without pain and climb stairs although you may need a stick to walk longer distances.

What is the Lifespan of a Revision TKR?

The lifespan of a revised TKR depends on the reasons for revision and the complexity of the procedure. There is a better than 80% chance that two operations for revision of an infected TKR will result in a knee replacement that is free of infection.

Longevity of a revision knee replacement will be less than for a primary TKR but 75-80% should be still functioning after 10 years.

I want to thank Mr. Datta for taking such good care of me during both hip replacement procedures. It was my first major surgery and he helped calm my nerves. Both surgeries were successful and the after care was excellent. I am now completely pain free and able to do things I was not able to do for a number of years.

S Kirby

I must say my overall experience at Spire under Mr Datta was first class and I am very grateful to all involved

Peter L

My care and treatment has been excellent. From my first consultation through to my surgery, I have been kept well informed and have had all the information I’ve needed to ensure the surgery went well and that I make a speedy recovery. I would highly recommend Mr Datta.

Mr King

I had a total knee replacement done and had the best care. Yes did experience a long wait to go to surgery but that's expected in most hospitals. Was in for 3 days and couldn't fault the care, nurses and cleanliness of the hospital. Lovely food. One nurse in particular always managed to make me smile

P Elliott

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