Revision Knee Replacement Surgery

• There are a number of reasons why a knee replacement may need to be surgically removed and replaced with a new implant (a revision):
• Loosening or wear; total knee replacements and partial knee replacements have been around for over 40 years.. There have been great advances in the materials that we now use but older implants can loosen from the bone or the bearing surfaces can wear out.
• Progression of arthritis; in partial knee replacements the remaining joint could also demonstrate progressive damage. Newer techniques minimise this risk, making partial joint replacement an excellent option.
• Fractures near the implant; as bone weakens with age it becomes easier to sustain a fracture from a fall. If the fracture is near an implant it may loosen it. Total knee replacements are more prone to this problem than partial knee replacements.
• Infection; This can either early near the time of surgery or later coming from spread through the body. A deep seated infection can sometimes be impossible to eradicate without revising the implant.
• In all circumstances it is vital to look at why this has occurred and the type of procedure required to revise the replacement; replacing the old implant with a new one. I am part of a regional network where all cases are discussed with a multidiciplinary team of surgeons, radiologists and microbiologists. This ensures best possible care in these sometimes very complex cases.
• It is common for revision knee implants to require a more invasive approach. Longer stems inside the bone and a more stable joint mechanics provide enough support for the knee.