Revision Total Knee Replacement

1) What is a Revision Total Knee Replacement?

In patients over age 60 years, it is hoped that a total knee replacement will last the lifetime of the patient. Occasionally, implants fail for a variety of reasons such as polyethylene (plastic) wear, loosening, instability or deep infection. A revision total knee replacement often involves removing the implant put in during the first operation, and replacing this with a new total knee device.

2) What Results Can I Expect?

Revision total knee replacement is a more difficult and lengthy operation than the initial total knee replacement but can offer extremely good results in terms of pain relief and restoration of function. The chances of an excellent result are slightly lower than those of the primary procedure, but still in the range of 80-90%.

3) What Are the Risks of Revision Total Knee Replacement?

As with any operation, a revision total knee replacement has a number of potential risks. These would include:

• Anesthetic complications
• Flaring up of a medical condition(s)
• Deep vein thrombosis and pulmonary embolism (blood clot in legs or lungs)
• Death(0.7%)
• Infection (approximately 2-5%)
• Slow healing
• Slowconvalescence
• Technical complication (ie. damage to skin, muscle, bone, nerve or blood vessel)
• Post-operative instability of the knee
• Knee stiffness
• Late wear and loosening of the implant needing revision (approximately 1% per year)
• Limp

4)  What Happens in Revision Surgery?

A revision total knee replacement usually takes 1.5 to 2 hours to perform. The surgeon must:

• expose and remove the failed implant
• re-insert all or part of a new total knee replacement depending on what had to be fixed

5) What Happens After Revision Surgery?

The information in the Guide will generally apply to you. However, after a revision total knee replacement, your weight bearing and exercises may be more restricted than with your first replacement. You may require a brace while you are recovering.