Knee replacement is a highly successful procedure, delivering life changing benefits that allow you to resume your favorite activities and live a pain free life. For most knee replacement patients, results are very long lasting. A recent study has shown approximately 90% of knee implants will last at least 20 years; however, in some cases, your knee replacement may fail.
When a knee implant fails, you may experience pain and swelling in your knee. You may also find that the joint becomes stiff or unstable, making it challenging to enjoy many of your favorite activities.
In most cases, revision knee surgery may be required to repair a failed knee replacement. During this procedure, one or more components of the prosthetic knee implant are removed and replaced. Depending on the specifics of your failed knee replacement, the bone around the knee may need to be rebuilt as well.
Age is one of the most common factors impacting whether you will eventually need revision knee surgery. Since the prosthetic implant wears out over time, patients who undergo initial knee replacement at a younger age are more likely to need a second procedure down the road. For example, a patient undergoing knee replacement in their 40s or 50s is a lot more likely to live 20+ years and need a revision procedure due to normal wear and tear than a patient undergoing their initial procedure in their 70s.
There are other factors besides age that may impact your need for revision knee surgery later. There are a variety of reasons why a knee replacement may fail, even when the procedure was performed properly and achieved an excellent outcome.
Infection is a risk associated with every surgical procedure. While infection after knee replacement is very rare, it may occur in some instances, and it is the most common reason for early failure of a knee replacement. When there is an infection, you may experience pain and stiffness in the knee joint, and the implant may not stay attached to the bone. This may make revision surgery necessary.
Revision knee surgery after infection is a specialized procedure and may be performed in two different ways:
If excessive scar tissue develops around the knee joint, it may inhibit full range of motion. The most common treatment for this issue is a procedure called “manipulation under anesthesia.” This minimally invasive procedure involves moving the knee joint through a series of extension and flexion manipulations to break up the scar tissue. Aesthesia is used to minimize discomfort.
If stiffness remains after this procedure, revision knee surgery may be required to restore full range of motion.
Instability may occur if the ligaments and soft tissue surrounding the knee joint become damaged. This lack of stability may prevent the implant from functioning properly when you stand, walk, and perform a variety of other activities.
Initial treatment for instability typically involves bracing and physical therapy. However, revision knee surgery may be required if these nonsurgical methods aren’t able to restore proper stability.
Fractures can occur from falls or other trauma to the knee region. When broken bones occur right near the components of the implant, it may compromise the proper function of the prosthetic knee replacement. Revision surgery is typically required to restore proper function.
There are several factors impacting the extent of your revision knee surgery, including:
This is one of the most common causes of revision knee surgery. As discussed earlier, even successful knee replacements may fail 15 to 20 years (or sometimes longer) after the initial surgery. This is due to a loosening or breakage of the knee implant components over time. Regular use of your knee joint will eventually cause the implant to wear out. Once this impacts proper function or causes pain, you may need a revision procedure to replace the damaged implant with a new one.
It’s important to understand that revision knee surgery is generally more complicated than an initial knee replacement procedure. Additional preoperative planning is required, specialized instruments must be used, and greater surgical skill – including the mastery of difficult techniques – is required.
There are several reasons why revision procedures are more complex:
In addition, surgical time may be longer for revision knee surgery, and there is greater risk of complications.
For these reasons, it’s crucial to work with an orthopedic surgeon who specializes in revision procedures.
Revision knee surgery is performed under general anesthesia. During the procedure, an incision will be made along the same location used for the incision in your initial knee replacement. However, the new incision may be a little longer to facilitate the removal of the old implant components which have failed.
Dr. Borchard, our orthopedic knee, hip, and shoulder surgeon, will examine the soft tissue in your knee joint to ensure the region isn’t infected. In addition, the components of the implant will be assessed to determine which ones need to be removed or repositioned.
Any damaged components of the original implant will be removed. Dr. Borchard will take great care to preserve as much natural bone as possible.
After all components are removed, Dr. Borchard will prepare the bone surfaces to accommodate the placement of the new implant. If significant bone loss has occurred around the joint, platform blocks and metal support rods may be added to provide additional support. If necessary, a bone graft may also be performed at this time to rebuild the lost bone in the knee joint.
Finally, Dr. Borchard will insert the new knee implant, repair any damage to the surrounding soft tissue and test the joint’s range of motion.
You’ll spend a few hours in the recovery room until the anesthesia has worn off. At this point, you’ll move to a hospital room. You may need to spend several days in the hospital before returning home to start rehab. Physical therapy often begins while you’re still in the hospital to start strengthening your knee and restoring your range of motion.
Colorado Advanced Orthopedics is the premier orthopedics clinic along the Western Slope of Colorado. All knee replacement procedures are performed by Dr. Kevin Borchard, a board-certified orthopedic surgeon with fellowship training in knee reconstruction. He has extensive experience performing complex knee replacement procedures and has made revision knee surgery an area of specialization.
In addition to receiving treatment from some of the most highly trained surgeons in the country, you’ll work with a dynamic, caring team that is committed to providing an amazing experience throughout every stage of your procedure. At Colorado Advanced Orthopedics, you can always count on:
Contact us today to schedule an appointment. Colorado Advanced Orthopedics serves patients in Meeker and throughout the White River Valley.
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