REVISION KNEE REPLACEMENT
Revision total knee replacement is performed when the
original primary total knee
replacement has worn out or loosened in the bone. Revisions are also
if the primary knee replacement fails due to recurrent dislocation,
or very rarely, ongoing pain and significant leg length discrepancy.
The revision total knee replacement is a more complex
procedure, often because
there is a reduced amount of bone to place the new total knee into.
may be required and this is usually received from a bone bank. Bone
(allograft bone) is safe and has been irradiated to eliminate any
chance of disease
transmission. There are also artificial bone substitutes that may be
Revision total knee replacement takes longer than a
standard total knee replacement
and has a slightly higher complication rate. The prosthesis may also
not last as long
as a primary knee replacement. Surgery is usually performed through
incision but may need some extension. The risks and complications are
standard knee replacement surgery.
As anybody undergoes general or regional anesthesia
(epidural anesthesia) there
are always risks associated with it. The risks of course are magnified
if you have
abnormal general medical conditions in addition to your older age,
have affected the functions of your vital organs such as heart, lungs
Therefore a complete evaluation of those systems has to be performed
are taken to the Operating theatre.
Specific complications relating to knee replacement
surgery include the following:
- Deep vein thrombosis: This is
prevented by giving blood thinners and if it occurs
it is treated with specific blood thinners.
- Infection: The risk of infection is
less than 1% and pre-operative antibiotics are
given to prevent this from happening.
- Stiffness: Occasionally knee
replacement may stiffen up particularly in patients
who are significantly overweight or have diabetes. Occasionally one
a manipulation under an anaesthetic should this occur.
- Nerve and vessel damage: It is
unlikely that any major nerve or vessel will be
damaged. It is unlikely that any major nerve or vessel will be
damaged. It is,
however, very common to have a small area of numbness over the other
of your knee where a superficial skin nerve is always cut during the
This little numb patch is of no significance.
- Prosthesis failure: The prosthesis may
fail due to the plastic wearing out and it
may require revision.
- Reflex sympathetic dystrophy: Very
rarely a condition can occur where the leg
becomes stiff, hypersensitive and painful. This requires specific
a pain management specialist.
- Excessive bleeding around the joint:
This usually settles but may require drainage.
- Excessive scarring: Some skin will
scar up significantly (keloid).
- Fluid build-up in the knee joint:
Occasionally this may occur and require drainage.
It is usual for knees to be a little swollen and a little warm.
- Pain with kneeling: Kneeling may
produce discomfort over the incision site.
A total knee replacement often takes at least six months to settle