What is a revision knee replacement?

A revision knee replacement is an operation which involves the replacing of previous implants, or in some cases making small adjustments which are vital for maintaining a knee replacement.

Why is a revision knee replacement needed?

There are several reasons why a revision knee replacement may be required.  The commonest reasons are wear of plastic insert and implant loosening.  A revision knee replacement for worn plastic requires a fairly straightforward swapping of this plastic insert. The problem of implants coming loose and osteolysis, which is an erosion of the bone that causes pain and stiffness, can also be rectified by replacing all implants during revision surgery.

Other reasons for revision include infection which results in swelling or fever symptoms and instability that makes walking hard for patients.

What does revision knee replacement surgery involve?

The nature of each revision knee replacement is entirely dependent on the type of revision which is required. The surgeon will use the previous skin incision to expose the knee joint. Usually, revision surgery is more complex and requires specialized instruments and implants. Sometimes bone grafting may be required to replace the lost bone. The surgery can sometimes take up to three to four hours to finish depending on the complexity of the procedure.

Recovery time

Following a revision knee replacement, patients typically stay in hospital for between three to five days, and crutches are usually used for a period of four to six weeks. Following this time, smaller walking aids such as a walking stick are often used for support.

Physical therapy is a crucial element of recovery following a revision knee replacement and can be started almost immediately following surgery. Activity level and the intensity of exercises can be ramped up gradually, with a tailored programme for a patient being provided by a physiotherapist. The overall recovery time is longer than a primary knee replacement and residual pain and swelling can take 6-12 months to settle down.