While knee replacement has enjoyed tremendous success for the vast majority of patients, there remains a small percentage of implants that can fail overtime. Unfortunately, when implant failure occurs, a revision operation is often required. Revision surgery involves removing a portion or all of the original implant and replacing it with new components.
Knee replacement revision is often a more complex procedure than “primary” replacement and may require specialized implants. Extensive pre-operative planning is usually necessary and these procedures are often performed by fellowship-trained hip and knee replacement specialists like Dr. Melvin.
Do I need a knee replacement revision?
A thorough and detailed work-up by Dr. Melvin is necessary to determine the cause of your knee replacement’s problem and to formulate a comprehensive treatment plan. Symptoms that the patient may experience or signs that the surgeon recognizes that could be related to implant failure include:
- Joint swelling due to infection, wear, or implant loosening
- Declining joint function, resulting in knee stiffness or instability
- X-ray changes in the condition or position of the prosthesis
Reasons for knee replacement failure
Knee replacements can fail for a number of reasons. The most common reasons for implant failure include:
- Loosening. This can be due to a number of factors. The femoral, tibial or patellar component can loosen from the bone or cement. This can cause instability, deformity or pain. In some cases, the bone may become weakened as a result of the loosening, causing a fracture.
- Infection. While the risk of infection is very low, it is still a relatively common reason for patients to undergo knee replacement revision surgery.
- Instability. The knee is a complex joint. Occasionally, imbalance between the prosthesis and knee ligaments can occur due to wear or ligament laxity. This can lead to pain and the sensation that the knee is unsteady.
- Wear. The bearing surface can wear down over time. Improvements in the plastics have greatly reduced this complication, but it remains a cause for revision.
Knee replacement revision procedure
Because the reasons for knee replacement revision vary among patients, the details of the procedure will vary as well. The procedure typically involves removing a portion or all of the original implant and replacing it with new components. Dr. Melvin will review the detailed surgical plan with the patient prior to revision surgery.