Why knee replacement fails?
Total knee replacement may fail for a variety of reasons. Common causes of failure are wear/ loosening of the prosthesis , infection, instability and peri-prosthetic fracture.
What are the common symptoms?
When this occurs, the knee can become painful and swollen. It may also feel stiff or unstable, making it difficult to perform your everyday activities.
How is it different from primary knee replacement?
Revision surgery is different than primary total knee replacement. It is a longer, more complex procedure that requires extensive planning, and specialized implants and tools. The old /damaged implants are removed and replaced with new constrained implants.
final implantation of revision components
What causes loosening of implants?
The cause of loosening is not always clear, but high-impact activities, excessive body weight, and wear of the plastic spacer between the two metal components of the implant are all factors that may contribute. The immune response to wear particles generated over years due to friction between metal and plastic spacer causes bone loss (osteolysis) and loosening of components.
What is septic revision?
Infection is a dreaded complication of joint replacement surgery. In a proven joint infection , implant must be completely removed along with debridement of the infected tissue as a first stage procedure. We usually place a temporary cement spacer in your knee. This spacer leaches antibiotics to fight the infection and will remain in your knee for twelve weeks. During this time, you will also receive intravenous antibiotics. Once the infection has been cleared, a second surgery is done to remove the antibiotic spacer and insert a new prosthesis.
Infected Knee showing sinus
Antibiotic cement spacer used for staged revision of infected knee
What are the other reasons for Revision?
Instability is another reason for revision. If after your knee replacement ,the knee is “giving way.” or is buckling, either it has not been balanced properly or some soft tissue/ligament has ruptured/broken. If knee instability cannot be treated through nonsurgical means such as bracing and physical therapy, revision surgery may be needed.
Periprosthetic fracture that occurs around the components of a total knee replacement. These fractures are most often the result of a fall. If the components of the knee prosthesis are loose after injury, they usually require revision surgery.
In determining the extent of the revision needed, we consider several factors, including the quality of the remaining bone, the type and location of the fracture, and whether the implant is loose.
What are the complications of revision surgery?
Poor wound healing, stiffness in the knee, infection in the wound or the new prosthesis, bleeding, blood clots, bone fracture during surgery and injury to nerves or blood vessels may occur rarely.