Revision Total Knee Replacement
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What is a revision?
A knee joint revision surgery is a procedure done when total knee replacement fails. It is essentially a "redo" of the first surgery. There are many different modes of failure for knee replacements. A failed surgery or implant can lead to significant pain and disability. Our Atlanta surgeons are able to fix the smallest to largest knee replacement failures and perform complex knee revision surgery on patients from all over the southeastern United States.
Front (AP) view of a total knee replacement with loosening of the femoral (thighbone) prosthesis, seen by a lateral shift of component.
The same front (AP) view showing a revision implant
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Side view (Lateral) of a knee replacement that has failed. The femoral (thigh bone) component has detached from the bone
The same side (lateral) view showing the revised knee replacement.
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Why do knee replacements fail?
There are numerous reasons why knee replacements fail. A variety of factors must be assessed in order to delineate what the problem is with the joint. Patients may suffer from infections (less than 1%), failure of the plastic, implant failure, loosening after a fall, allergic reaction, wear of the plastic over many years, etc. When knee replacements fail, patients can be severely debilitated. Our group believes in identifying the problem, explaining the root cause of the problem, then addressing it to our patients satisfaction. From infection to breaking a bone around the implant, our knee replacement specialists are all capable of restoring your function! Turn no further, we're here to help. Click to fill out our survey and let us review what's wrong with your knee replacement.
How do I know if my knee replacement has failed?
Infection
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" or "biodome"
and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to eradicate the infection and get you your life back!
Aligment Problems
In total knee replacements, poorly placed components with incorrect rotation can lead to knee stiffness. Our surgeons will take X-Rays and see if this is part of the problem leading to stiffness. When the knee is not aligned well, the kneecap may not track appropriately and this can lead to severe stiffness and anterior (frontal) knee pain.
Plastic Wear
Think of the plastic in a knee replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a knee joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction from the cells in your body that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
Although extremely rare with knee replacement, a dislocation occurs when there is extreme instability or possibly even an injury to the patellar tendon or quadriceps tendon. This is a devastating complication and requires revision to complex entities.
Stiffness
There are many reasons why a joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," where the knee is placed through a range of motion to break up the scar tissue in the operating room while the patient is asleep.
Heterotopic Ossification
Albeit rare, after knee replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation why. However, this can be a significant source of stiffness and can severely limit patient mobility. It is very rare in the setting of a knee replacement.
Component Failure
Extremely rarely, the components may fail or come apart. In this rare condition, the surgeon must replace these components. Examples include the plastic cracking or the implant breaking. This is extremely rare.
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" or "biodome"
and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to eradicate the infection and get you your life back!
Aligment Problems
In total knee replacements, poorly placed components with incorrect rotation can lead to knee stiffness. Our surgeons will take X-Rays and see if this is part of the problem leading to stiffness. When the knee is not aligned well, the kneecap may not track appropriately and this can lead to severe stiffness and anterior (frontal) knee pain.
Plastic Wear
Think of the plastic in a knee replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a knee joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction from the cells in your body that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
Although extremely rare with knee replacement, a dislocation occurs when there is extreme instability or possibly even an injury to the patellar tendon or quadriceps tendon. This is a devastating complication and requires revision to complex entities.
Stiffness
There are many reasons why a joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," where the knee is placed through a range of motion to break up the scar tissue in the operating room while the patient is asleep.
Heterotopic Ossification
Albeit rare, after knee replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation why. However, this can be a significant source of stiffness and can severely limit patient mobility. It is very rare in the setting of a knee replacement.
Component Failure
Extremely rarely, the components may fail or come apart. In this rare condition, the surgeon must replace these components. Examples include the plastic cracking or the implant breaking. This is extremely rare.