When is a Second Knee Replacement Surgery Necessary?
More preoperative planning, specialized equipment, and advanced surgical skill are needed for the treatment. Compared to a primary first knee replacement, the surgery takes longer to complete.
A revision knee replacement procedure is typically advised in the following circumstances:
Implant loosening over time as a result of wear:
The implant needs to be firmly anchored to the bone for optimal knee movement after replacement surgery. Thus, the surgeon will either cement the implant to the bone during the original knee replacement surgery or let the bone develop over the implant.
However, with time, the bone-implant connection may deteriorate, resulting in the implant becoming loose and the patient experiencing pain. The following are the most typical causes of implant loosening:
- Traumatic activities
- Unhealthy body weight
- The plastic spacer deteriorating
- Patient outlives the original implant’s useful life
- Osteolysis and bone deterioration around the implant due to an autoimmune response to the implant
Implant infection following primary knee replacement surgery:
The infection may develop right away following the procedure or even years later. An infected implant will hurt, stiffen the joints, and possibly even cause the implant to come free.
There are two techniques to undertake revision surgery in the event of an infection.
- The plastic spacer is changed, and the metal implants are cleaned to get rid of the infection, in the first method, known as debridement and implant retention.
- Staged surgery is the second approach. The implant is taken out during surgery, and the joint is cleaned. An interim spacer is then inserted, and the patient is then given intravenous antibiotics to treat the infection. A new prosthetic is inserted when the infection has been treated.
Joint instability:
The implant may become unstable and impair normal joint movement and function if the ligaments supporting it suffers injury.
Implant stiffness: The connections around the implant may occasionally develop scar tissue, resulting in a constrained range of motion. If this occurs, the surgeon has two options
- either try to remove the scar tissue
- or replace the implant parts that have the most scarring surrounding them.
Fracture of the implant or bone:
Fractures of the bone surrounding the knee prosthetic (periprosthetic fracture) may require revision surgery for the patient. Implant or bone fracture. In rare circumstances, the entire broken bone fragment may be removed and replaced with a bigger implant.