The success ratio for knee replacement surgery stands at an astounding 85-90%, but there are still cases where you might need a knee replacement revision. You could face this issue if you had your knee replacement surgery 15 to 20 years ago or due to failure. The objective is to do another operation to re-fixate implants or replace prostheses and clean the bone surface.

From who may need a knee revision surgery to what happens afterward, here are answers to some of the most frequently asked questions about knee replacement revision:

What is a knee revision?

It’s a complex procedure to fix the prosthetic implants in a person who has had a total knee replacement before. 

Who needs a knee revision surgery?

People whose knee implants have worn out over the years due to physical exertion or those suffering from an infection need to undergo this surgery. The most common indicators that knee revision surgery is required are:

  • Wear and tear in the prosthesis components over time
  • Instability in walking and standing due to weak tissues around the knee area
  • Excessive scar tissues around the knee area causing stiffness
  • Infection from a total knee replacement surgery

Who is at most risk of knee replacement failure?

People’s activity levels, surgical history, and weight determine how successful their knee replacement surgery is. Placing stress on the knee, obesity, and prior knee surgeries can contribute to a failed operation and require a knee replacement revision.

What’s the diagnostic process for knee replacement revision?

An orthopedic surgeon will order a comprehensive clinical exam, including X-rays, laboratory tests, and bone scans. Joint fluids aspirated from the knee are used to determine infection. CT scans and MRIs are used to pinpoint the location of loose or broken prosthetic components. 

What happens during the procedure?

Surgeons remove the old implants and use bone grafts to fill the gap depending on the loss of bone. They might use metal wedges, screws, and wires to strengthen the bone and place a new implant. Temporary drains and specialized negative pressure incisional dressings are used to reduce swelling and improve healing, respectively.

What happens post-operation?

After the surgery, patients will undergo physical therapy to regain their function. Braces and splints are employed to protect the knee joint, and pain medication is administered.

What is the total recovery time?

The recovery time may take up to three months. Physiotherapy can be started after 24 hours, and eventually, assistive devices can be introduced to help regain full function.

What are the risks involved in a revision knee replacement?

Due to the complexity of the procedures, patients face these risks:

  • Infection
  • Nerves damage
  • Intra-operative fractures
  • Bleeding and blood clots (pulmonary embolism)
  • Wound drainage issues
  • Prior lung and heart conditions can be exacerbated

What is the success ratio of knee revision surgery?

Most patients recover their knee function and stability and enjoy relief from pain post-surgery. However, success also depends on the severity of the condition and post-op care.

Who should I contact for a consultation?

While these FAQs can answer the most common questions, we recommend you consult with a professional orthopedic surgeon to get a proper diagnosis. Dr. David Thorsett at Santiam Orthopedic Group provides comprehensive treatment plans for knee surgery revisions. To schedule an appointment, please call 503-769-8470. 

Knee Surgery