Medically Reviewed by Christopher P. Walsh, MD

Although today’s knee joint replacements are designed to last decades, occasionally one will wear out or, for some other reason, need to be replaced.  McLeod Seacoast Orthopedic Surgeon Christopher Walsh, MD, explains the signs you may need a replacement and what to expect after revision surgery:

Here’s a summary of Dr. Walsh’s comments:

A knee replacement revision occurs when patient has a previous total knee joint replacement that is not functioning as it should.

There can be a number of different causes of a patient’s pain — instability, infection or loosening. Through evaluation in the office, we can just decide what is the best course of action for the patient.

A complex revision involves removing either some or all of the previously implanted components and revising to newer components that address the issue. Revisions are much more complex procedures than the initial joint replacement, because we’re working through skin and tissue that has already been cut through and there is scar tissue involved. Sometimes there’s instability of implants that cause loss of bone and loss of strength of the ligaments around the implant.  So, you have to take all of these different factors into account in selecting the right implant for the patient and the right procedure to perform on the patient.

Whenever we put in a primary replacement, our goal is to avoid any revisions. But, if the knee is not performing up to the patient’s standard, then revision is something to consider. A goal of the revision surgery is to treat a problem and return the patient to the level of activity that they desire.

Long-term outcomes of complex revisions are quite good. There is a chance of some loss of function, but normally that’s a small range of motion loss and patients are able to continue doing activities that they want to do and that they were unable to perform with their previously implanted joint.

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