At Spire Clare Park Hospital in Farnham, Surrey, we have several orthopaedic surgeons who carry out revision knee replacements routinely. They work within our laminar flow theatres to reduce the risk of infection. With the support of our physiotherapists, you will be up and about and ready to go home within a matter of days. Ask your GP for a referral to the orthopaedic team Spire Clare Park Hospital. Alternatively, contact the customer services team for more information.
About revision knee replacement surgery
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 in 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 first, 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.
The two X-ray images below illustrate the differences between the original and revision knee replacements.
1) Loose and painful knee replacement
2) Revision knee replacement
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. 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.