Revision Knee Replacement Surgery Information for Patients
Indications
Total knee replacements that have failed either because of wear of the bearing surfaces or for other reasons such as implant loosening may require revising or re-doing. The operation is normally carried out for pain arising from the loose or worn joint hip joint. The operation may also be necessary for progressive bone loss where a loose knee replacement is destroying bone, which may occasionally be a painless process. A revision of the knee is then essential and necessary to stop this process from progressing.
Operation
Revision knee surgery for whatever cause is complex and must be tailored for the individual patient and their problem. The operation is carried out under either a regional (epidural) anaesthetic with sedation or a general anaesthetic depending on the patients’ medical needs. This will be discussed with you by the Consultant Anaesthetist should you need to have such an operation.
Following the operation, the patient may require post-operative support in a High Dependency Unit (HDU) for 24 to 48 hours. Protected mobility (partial weight bearing) maybe necessary for some weeks following such surgery. Normally the patients return home after some 7 to 10 days following surgery. They should be able to negotiate stairs and walk with two crutches possibly requiring crutches for six weeks. Driving is not permitted for six weeks.
The type of implant used in knee revision surgery is important and is dependant on a number of variable factors. This needs to be discussed in detail to explain the type of implant to be used and the specific needs for such surgery. Where bone is deficient around a knee replacement there are revision knee systems that allow these defects to be overcome by using augments. Where there is a deficiency in the ligament structures around the knee, there are stabilised knee revision systems that will ensure stability following surgery
All patients are seen at six weeks for a check up and an X-ray and follow up is continued until satisfactory mobility has been regained.
Your Surgeon and the Operation
The reconstruction of a failed knee joint requires expertise in hip joint surgery and is a relatively complex and demanding procedure requiring understanding and compliance from the patient and the attending staff. You should always ensure that your surgeon is sufficiently experienced in such surgery. Mr Drabu would be happy to discuss details of his expertise and experience and results in this field and answer any questions or concerns you may have.