Frequently Asked Questions
Revision Knee Replacement
A revision knee replacement is a surgical procedure to replace or repair a previously implanted knee prosthesis that has failed or is no longer functioning properly. This will help in addressing the problems of pain, loosening of the implant, infection, or mechanical failure of the implant.
Chronic Pain: The patient has persistent pain or soreness with conservative treatment.
Loosening of Implant: The implant is loose/unstable as indicated by an imaging study.
Infection: Deep infection in the knee joint.
Mechanical Failure: The prosthesis has failed or is showing a wear and tear pattern.
Limited Function: There is inability to carry out activities of daily living because of knee dysfunction.
Revision knee replacement consists of the removal of the existing implant and its replacement with a new one. The surgery may include:
Bone preparation: cleaning off old cement or pieces of implant for preparing the bone for a new implant.
Tailor made Implant placement: correctly positioning and aligning the new prosthesis, which may be specifically tailored in its positioning and alignment to meet particular needs of the patient.
Repairing surrounding tissues: repairing damaged tissue or ligaments.
It takes around 2-3 hours to perform and is done under general or spinal anesthesia.
Revision knee replacement needs more time for recovery compared to primary knee replacement. Most patients are able to walk with support within one or two days of surgery. The full recovery and resumption of normal activities take around 6 months along with additional physical therapy to get good strength and mobility.
Risks include chances of infection, blood clots, implant failure, stiffness, and prolonged recovery since the revision procedure is often more complex.
With newer implant technologies and improved surgical techniques we use , revision knee replacements have the potential now to last 20 years, and even longer in certain cases. The longevity of the implant will, however, depend on various factors such as the activity level of the patient, weight of the patient, and general health of the patient.
It might involve further non-surgical treatment-avoiding surgery-with medicines, physiotherapy, or injections. If these fail to work and symptoms persist, then revision surgery is done.
Yes, but being overweight may raise the complications and could make the surgery more difficult. Even modest preoperative weight loss might result in improved outcomes and fewer risks.
Preparation includes:
Preoperative Testing: These include tests to check overall health and find out whether one is fit for undergoing this type of surgery.
Weight Control: Loss of weight, if recommended.
Physiotherapy: Pre-operative exercises to help strengthen the knee along with the surrounding muscles.
Life Style Changes: Whatever change one needs to bring about for easy recovery-planning a post-operative care and support and making necessary adjustments at home.
Yes, physical therapy is critical to a successful recovery. It helps restore strength, flexibility, and function to the knee. Your therapy program will be tailored by our team for your particular needs and may continue for several months depending upon your mobility recovery.
Complex Knee Replacement
A standard knee replacement typically addresses wear and tear in the joint due to osteoarthritis. A complex knee replacement, however, is required when there are more severe conditions, such as significant deformities, previous surgeries, bone loss, or ligament damage, which make the procedure more challenging.
Patients with severe knee deformities, infections, multiple failed knee replacements, extensive bone damage, or those with conditions like rheumatoid arthritis or trauma, may require a complex knee replacement.
While risks are similar to standard knee replacements, they may be higher due to the complexity of the surgery. Potential risks include infection, blood clots, prosthetic loosening, nerve or vascular injury, and a longer recovery period.
Recovery after complex knee replacement may take longer than standard knee replacement. Full recovery can range from 6 months to a year, depending on the patient’s condition, rehabilitation, and overall health.
Most patients experience significant pain relief and improved mobility after surgery. However, due to the complexity of the procedure, the outcomes may vary, and the rehabilitation process might be more intensive.
Complex and Complicated Knee Trauma Surgery
Complex knee trauma involves knee injuries that are severe: multiple ligament tears, fractures involving the knee joint, dislocation, and tissue damage to the surrounding structures that more often than not require complex surgical means in repair and restoration.
Complex knee trauma surgery is more involved because there is more damage. In most instances, restoring function and stability requires a combination of procedures: ligament reconstruction, fracture repair, and even sometimes the use of special implants.
The extent of the injury is such that the recovery may be slower and it takes longer to regain strength and mobility. Depending on the severity of trauma that was sustained, there may be a risk of complications such as stiffness, instability, or re-injury.
Possible complications include infection, clots, stiffness of the joint, chronic pain, and healing problems, especially if reconstruction of a bone or ligament is necessary. There’s also a possibility of the joint being unstable if the repair doesn’t restore function completely.
Recovery times certainly depend on the severity of the injury and also on the type of surgery performed. Generally, it may take several months up to a year for recovery; a structured rehabilitation program is usually necessary to regain strength, flexibility, and normal joint function.
Periprosthetic Fracture
A periprosthetic fracture is the break in the bone that usually occurs around a joint prosthesis, such as a knee or hip implant. Essentially, these fractures happen after joint replacement surgery and might be the result of trauma, a fall, or an osteoporotic or otherwise weakened bone.
Trauma is a common cause of periprosthetic fracture, as from a fall or other accident. In some cases, bones around the prosthesis have weakened over time due to osteoporosis or some underlying condition, making periprosthetic fracture more likely to occur. Sometimes, if the bone is under persistent stress around the prosthesis, a fracture can result.
Treatment of the fracture depends on the location and severity of the fracture, and can range from surgical fixation with plates, screws, or wires to stabilize the bone to revision surgery to replace the prosthesis. For less severe fractures, immobilization and physical therapy may be utilized.
These risks includes, but are not limited to, infection, clotting of the blood, poor healing of the bone, and loosening of the prosthetic. Patients with periprosthetic fractures may also have to bear the pain of a longer period of recovery due to the difficulty of the fracture and the surgery itself.
The time to recover might be different because of the grade of the fracture and the mode of treatment. Surgical patients may take many months, up to a year, for complete recovery, and physical therapy plays an important role in the return of strength, motion, and function.
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