Revision surgery of previously replaced knee in majority of cases entails  the removal of all existing components and replacing them with new ones. Usually they cannot be replaced with the same size and type of the components and need to be upgraded - this usually involves using a stemmed component to improve stability of the components and componsate for any bone loss.

The procedure is usually done under general anaesthetic. Whilst it can be done under spinal anaesthesia, the duration of the spinal anaesthetic is usually not long enough to allow for the procedure to be completed. These procedures are usually complicated and take a long time to complete with a lot of unexpected steps.

Knee revision surgery is usually recommended if you have:

• an infected total knee replacement,
• an unstable knee joint post replacement or unstable components in the knee,
• if there are any signs of wear and tear on the components, particularly on the plastic bearing part or
• if there are any other problems present with the knee replacement which cannot be addressed other than with revision surgery.

The procedure itself can take on average between 2-4 hours. It mainly depends on how complex the problem is and what needs to be done. Occasionally the removal of existing components and bone cement can be extremely time consuming, particularly if the bone cement has been inserted deep into the medullary canal of the tibia or femur.

Recovery is related to the complexity of the problem. The longer the surgery, the (very likely) longer the recovery. The higher the number of previous revision surgeries before the last, the longer the recovery is very likely going to be. On average it is expected that the recovery plateau will be reached in 6 to 12 months post procedure.

If you need a knee revision surgery it is very likely that your case will be discussed by a multidisciplinary (MDT) team which usually includes a plastic surgeon, an infectious diseases doctor, a radiologist and an orthopaedic surgeon. They will make a joint decision on which is the most optimal treatment in your case based on their experiences and current evidence in the literature.

The main risks or knee revision surgery are:

• Failure of treatment
• Intra-operative damage to nerves and vessels which requires further surgery
• Propagation or introduction of infection
• Unplanned fracture of your bones during the surgery and loss of limb
• Blood clots and pulmonary embolisms are also frequent complications of knee revision surgery which can have significant impact on your life

Further information can be found here and here. Alternatively get in touch via the contact form here or by telephone to book a consultation with Mr Krkovic.