Unfortunately this immune response also attacks the healthy bone around the implant, producing a condition called osteolysis. Osteolysis causes the bone around the implant to deteriorate, making the implant loose or unstable.
When this occurs, the knee can become swollen and painful to move, making it challenging to do everyday activities.
Infection is a possible complication in any surgical procedure, including total knee replacement. An infection may occur at any time from shortly after surgery to years later. Infection can spread from recent colds or urinary infection to involve joint replacement.
If an artificial knee joint becomes infected, it often will become swollen, painful and stiff. The infection may cause the implant to lose its attachment to the bone. Infection around a knee replacement requires one or more revision surgeries to treat the infection.
Most implants are designed and rely on the patients existing ligaments for the knee replacement to work appropriately. If the ligaments around the knee become damaged during or after the surgery or were improperly balanced, the knee will likely feel unstable and loose. The patient may experience recurrent swelling and the sense that the knee is “giving way.” If knee instability cannot be treated with nonsurgical processes such as physical therapy and bracing, revision surgery may be needed.
Rarely, patients are unable to appropriately rehab a knee replacement after surgery and the knee will get stiff. If this is not treated within the first few months by physical therapy or a manipulation under anesthesia, the stiffness will persist. In this case, revision surgery may be necessary to remove the extensive scar tissue and/or change the components in the knee to improve the patient’s range of motion.
A periprosthetic fracture is a broken bone around the components of a total knee replacement. A fall most often causes this type of fracture, and usually requires revision surgery.
In establishing the extent of the revision required, the Orthopaedic specialist will take into account a number of factors, including the location and the type and of fracture, the quality of the remaining bone, and if the implant is loose. Revision surgery may require fixing the fracture alone, fixing the fracture and revising the implant, or completely removing the implant and fracture pieces and replacing with a larger more complex total knee replacement.
How We Can Help
If you are experiencing pain or problems with your knee replacement, an evaluation with our fellowship-trained Orthopaedic surgeon is recommended. Dr.Potla Sivaiah performs revision knee surgery. He will evaluate the entirety of your case to determine if revision surgery may be right for you. This evaluation will include a review of your prior surgical documents and images, a detail physical exam, and often an array of specialized tests looking for potential reasons for your symptoms. With this, the potential benefits of revision surgery will be explained in detail to the patient.
Although with the same goal to reduce pain and increase function, revision surgery is different from first time total knee replacement. Revision surgery is often longer and more complex requiring specialized planning, tools, and implants to achieve a better result.
There are different types of knee revision surgery. In some cases, only one piece of the prosthesis has to be replaced. In other cases, multiple or all of the components need to be replaced. More complex revisions often require specialized implants and augments to replace damaged bone and ligaments.