A total knee replacement involves replacing the natural, damaged joint with an artificial joint, which is fused to the bone on both sides and allows the joint to bend freely and painlessly. In most cases, a total knee replacement can be expected to last around 15-20 years. This is only an estimate and each individual patient experience with joint replacement is different. Ultimately, there are a variety of reasons why a prosthetic knee joint may fail, including:
- Mechanical loosening: the artificial joint begins to separate from the bone
- Infection: an infected joint will become stiff and painful, and potentially loose as well.
- Bone fractures: If the bone fractures near the artificial joint, it may be necessary to replace the original prosthesis with a new one with longer stems that will fix the fractures like a metal pin.
- Instability: partial or complete dislocation of the artificial joint can cause unsteadiness, limited range of motion, and intense pain.
- Wear and breakage: over time, parts of the artificial joint may simply wear out and even break, requiring that either part or all of the implant be replaced. This is more likely in patients who engage in high-impact activities or who have had their knee replacement for a long time.
Revision total knee replacement surgery is a complex procedure that requires specialized tools and implants, meticulous preoperative planning, and mastery of complex surgical techniques to achieve a successful outcome. For these reasons, it is critical that you select a surgeon who has extensive experience performing revision total knee replacement procedures. Dr. Lige Kaplan is a talented orthopaedic surgeon with extensive training and experience in revision surgery. He will work with you to understand the benefits and risk of revision surgery, and whether it is right for you. He will address any concerns you might have and work hand-in-hand with you to ensure that you are completely comfortable with your customized treatment plan.
Procedure and Recovery
A revision total knee replacement typically occurs in two distinct phases. First, the surgeon will need to remove the existing prosthetic joint. Because the old implant may be fused or cemented to the bones, some bone may also need to be removed as well. A new artificial joint made of either cobalt chrome or titanium is then cemented into place with the addition of stems augments or void-filling cones for added stability of the already weakened bone. This helps to create more surface for the new prosthesis to bond to. Because the bone is no longer the original shape, the surgeon must use a specialized prosthetic implant that has been tailored to match the bone structure of each individual patient. This prosthetic may also be longer to accommodate the loss of original bone structure
Recovery from a revision total knee revision is similar to recovery from a primary total knee replacement. A hospital stay of 1-3 days is usually required, although most patients are encouraged to stand and walk as quickly as possible, even within hours of the procedure. Early mobilization helps to facilitate the process of bonding the new implant and growing new bone, reduce the risk of stiffness and scar formation, and lessen the likelihood of a blood clot forming. Regular physical therapy is usually recommended for several weeks after the procedure. Within several months, the majority of patients are able to resume normal, low-impact activities. It is important to note that a revision total knee implant is likely to last around 15-20 years, or longer, if appropriately taken care of and it is not meant to function like that of a primary implant.
The rehabilitative process after revision surgery is longer, slower and more unpredictable than primary or first-time joint replacement surgery. Recovery and ultimate outcome varies widely and will depend on patient factors (age, comorbidities, weight, compliance), amount of bone loss and magnitude of surgery.
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