Definition:
The revision total knee replacement is a surgical procedure performed at the time when initial total knee replacement gets loosened or worn out. This surgery is also carried out if primary total knee replacement fails because of persistent dislocation, infection and fracture. It is termed as a very complex surgery because of the availability of very less bone to place metal implants. In this case, the bone is taken from the bone bank. As compared to the total knee replacement surgery, it takes longer time and has higher complication rates. Another problem in the revision total knee replacement is that the prosthesis may not last longer, as they did in initial surgery.
Generally, the need for revision surgery arises after a span of 10 to 15 years after the initial surgery. The revision surgery is done to remove old knee replacement, leaving as much original bone as possible. During this process, there is a chance of a considerable amount of bone loss; if the old knee replacement gets infected. This calls for a need to do two operations. First operation involves removal of old knee replacement after giving anesthesia. Then, antibiotics are given to exterminate the infection within 4-6 weeks. In the second stage, new knee replacement is inserted. The complication of loss of bone during removal of original total knee replacement is met with the help of metal blocks and stems attached to the main components. This lessens the risk of further infections.
Purpose:
Revision total knee replacement is carried out to relieve pain in the affected joints, removal of damaged prosthesis before irreparable harm is done to the joint and restoring patient’s mobility. There are two reasons that lead to the loosening of metal implants. Firstly, the prosthesis can loosen because of excess weight being put on them while running, walking and other activities. Secondly, the development of inflammation in the knee joint causes problems in the original knee replacement. When knee prosthesis is completely dislocated, the doctors will ask you for this surgery to prevent permanent damage to the knee.
Precautions:
On completion of your revision total knee replacement surgery, you will have to be extra cautious about staying away from hard surfaces. It is because slight hit with such surfaces can cause extreme pain and further problems to the newly replaced joint. You will not be allowed to bend your knee beyond 90 degree, as this could possibly damage the artificial joint. Another thing to be used as a precautionary measure is the use of stick to avoid putting much weight on the revised implant.
Pre and Post Care:
Before starting the procedure, your physician will admit you for diagnosing the knee joint problem. The diagnosing includes certain x-rays that will show loss of cartilage and bone spurs. You might also be required to take-on blood tests for clearing the suspicion of rheumatoid arthritis. The doctor would also ask you to discontinue any medication prior to the surgery.
Apart from getting ready for the test and making certain preparations, many post care methods have to be kept in mind. You would be given blood thinning medication for avoiding deep vein thrombosis (blood clots). Your physician will guide you to make certain renovations at home such as small railing on the side of stairs, helper to pick things from floor, sock-aid for putting socks, so that you do not bend your knees beyond said level.
Risk Factors:
Even after repairing infected knee implants, this revision surgery also has risk factors. They are mentioned below:
- Infection
- Pneumonia
- Incision complications resulting from thinning of tissue, as compared to the one during original surgery
- Diabetes Mellitus
Hospital Stay:
You will be required to stay in the hospital for about 2 to 7 days, which includes pre-surgery examination, surgery and after care rehabilitation.
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