Total Knee Revision

Prosthetic knee implants often last 20 or more years and many patients go their entire life without the need for a knee revision. However, prosthetics can wear out and in those cases a revision may be necessary.



Patients requiring knee replacement surgery have damage to one or more bones in the knee joint including the femoral, tibial or patellar bone. Depending on the extent of damage, one or more of these bones may be removed and replaced with prosthetic (man-made) implant during knee replacement surgery. The need for a revision is typically the result of a slow breakdown of the prosthetic which is caused when implants rub against each other by movement of the joint (walking, running, etc.). This can eventualcly lead to mechanical wear, loosening and even breakage of the prosthetic. If a patient is younger or more physically active, wearing down of the prosthetic can be accelerated. Depending on the type of original implant used, microscopic particles of metal, plastic, ceramic or cement are released as the prosthetic wears. A revision is usually required when one of several things happen: the patient begins to experience pain once again, the prosthesis wears out or the prosthesis is recalled by the manufacturer.

If an orthopedic surgeon suspects that there is an issue with a knee replacement, a number of imaging tests, such as X-rays, CT scans, or MRIs, will be performed. These diagnostic tests show the surgeon the position and condition of the knee and prosthetic implants so they can determine if there is a need for revision surgery.

A knee revision involves surgically removing the prosthesis from the prior knee replacement surgery and replacing it with a new one. There are different types of knee revision surgery depending on whether one part of the knee needs to be replaced, several parts or all parts. In cases where there is damage to the bone, the orthopedic surgeon may utilize specialized implants that have longer, thicker stems to provide extra support inside the bone.

Surgery is typically recommended when one of the following occurs with a previously implanted prosthetic: the implant loosens or has worn out, an infection has developed prosthetic, the ligaments surrounding the knee become instable, damaged or improperly balanced, stiffness occurs in the knee and range of motion is limited, or if a fracture occurs around the components of the total knee replacement.

© 2017 St. Charles Orthopedics