Revision Knee Arthroplasty


A knee replacement lasts for about 20 years in the great majority of patients. Nonetheless, in a small percentage of cases, there is need for a second operation known as a revision knee arthroplasty. Reasons for implant failure vary, but once it occurs revision surgery is necessary to prevent permanent damage

Reasons for Revision Knee Arthroplasty

Typically, after recovery from an initial knee arthroscopy, a patient will regain normal range of motion and the joint will feel stable and comfortable. A small number of patients, however, will experience pain, stiffness or limited knee function. Reasons for problems after knee replacement surgery are varied.

Overuse

In recent years, a greater number of seniors live longer and remain physically active. This, coupled with the fact that younger individuals need knee replacements sooner than their forebears because of their increasingly energetic lifestyles, means that a larger number of patients need revision knee surgery simply because they have worn their implants out.

Instability

Although implants are firmly secured to the bone during surgery, at times they can loosen. This generally results from friction within the joint. It may also occur because of an injury, such as a fracture. The chances of the knee joint becoming unstable are greater if the patient is, or becomes, obese.

Infection

Post-surgical infection is uncommon, but always a possibility after an operation. If the tissue in the knee becomes infected, a revision may be necessary even if the implant remains successfully attached.

Inflammation

Although rare, it is possible that the implant can shift out of position. If this happens repeatedly, revision surgery is necessary.

Dislocation

Though fortunately uncommon, patients who have undergone knee arthroplasty occasionally develop an inflammatory response known as osteolysis around the prothesis itself. During this erosive process, particles of plastic can break off, causing inflammation as the cells around the knee joint absorb them. This is usually the result of wear and tear, sometimes exacerbated by an uneven walking gait.


The Revision Knee Arthroplasty Procedure

Depending upon the reason for the failure of the first knee replacement and the length of time that has elapsed since the operation, the surgical incision for knee revision may be made at the same site or in a different location.

In some cases, the revision procedure will be almost identical to the first surgery. In others, however, some reconstruction of the bone is necessary, using either a bone graft or metal plates and screws to secure the implant. Once the materials are fixed in place with cement, the surgeon will drain any excess fluid from the knee joint and suture the incision.


Recovery from Revision Knee Arthroplasty

After a revision knee arthroplasty, patients’ activities are restricted for 6 to12 weeks. Sometimes patients require braces for stability or assistive devices, such as crutches or walkers, to limit weight bearing and promote mobility. Physical therapy is essential for 2 to 3 months to improve knee strength and function.

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The Musculoskeletal Center

4 Centennial Drive, Suite 201 Peabody, MA 01960

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Mass General - North Shore

104 Endicott Street, Suite LL00 Danvers, MA 01923

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978.531.0800                  

Fax: 978-531-2929

At New England Orthopedic Specialists, patient health and well-being is our highest priority. In light of recent COVID-19 developments, patients should be assured that we employ the highest standards of safety and infection control protocols. We are continuously monitoring and following state and federal guidelines regarding avoiding potential exposure to the virus.

We are currently open and seeing patients at our location in Peabody. Based on the current recommendations, we are limiting patient visits to the office based on clinical needs. If you have an appointment and have not heard from us, you can plan on attending your appointment. However, if you are experiencing any cold or flu-like symptoms or may have had exposure to the virus through traveling or direct contact, please call us so that we can determine the best plan of action.

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If you have experienced a recent injury or are experiencing any serious orthopedic issues, please give us a call at 978-531-0800. Avoid the emergency room. Our Ortho Express is staffed and ready to care for your urgent needs, including availability of imaging and bracing, all in one location.