Total Knee and Hip Replacement relieve pain, restore function and provide long-term benefit. These may sometimes fail and require a second corrective surgery called “Revision” surgery. The causes may be due to the implant wearing out or loosening after many years. Occasionally a fall may fracture the bone near the implant requiring revision. Infection may occur in the implant. There may be failure due to technical reasons (poor alignment or balance). As Revision surgery is even more difficult than a first-time surgery, it requires greater experienced, equipment and instruments for a successful result.
When does the need for revision surgery arise?
Some of these problems develop within the first few months or years or, more often, develop many years after successful service.
What are some of the common reasons for revision surgery?
Wear and loosening
Instability and dislocation
Fractures around the knee implant
How do I know if I need a revision surgery?
A failed knee or hip replacement surgery can cause pain, swelling, discharge of pus or liquid from the operation scar, limp, inability to walk well; inability to climb stairs. After detailed examination and assessment with xrays, scans, and other tests, the need for revision can be confirmed.
What if I need a revision surgery?
Patients may need to perform several tests, x-rays, scans and even testing a sample of fluid from the joint to reach a firm diagnosis about the cause of revision.
If infection is the cause of revision, the operation may need to be done in 2 stages and antibiotics may need to be taken for a prolonged period of time.
As the causes of revision may vary from person to person, the investigations, treatment, results and costs will vary and will need to be individualized to each person.
How successful is revision surgery?
Revision surgery is an extremely challenging operation requiring even more experience, knowledge and technical expertise than first-time surgery. It usually takes twice the operating time as a first-time TKR and costs more too. Given a skilled surgeon, optimum techniques and implants, revision surgery has over 80% successful and durable results.
Example 2: This patient had surgery elsewhere and her left knee loosened out within 2 years; she required revision surgery
Example 1: This knee dislocated within few weeks of the operation which had been performed
elsewhere (xrays before and after revision TKR)
Example 3: Infection after total knee replacement. Pictures show a) condition of skin; b) 'spacer' after 1st stage TKR; c) xray after 2nd stage revision TKR; d) patient after 2nd stage Revision TKR