Revision Knee Replacement

What is a revision knee replacement?

A revision is a second operation on a knee that has already been replaced. Some or all of the original parts are removed and replaced. It is a more complex operation than the first one, and it is a large part of what Dr. Maish has done for his whole career: he has performed more than 2,000 revision joint replacement procedures.

Why a knee replacement may need to be revised

• Infection
• Loosening of the implant from the bone
• Instability, where the knee feels wobbly or gives way
• Stiffness
• Wear of the plastic insert
• A fracture around the implant
• Components that are not well positioned

It’s not in your head

Dr. Maish hears from people every week who have been made to feel that their complaints about a painful knee replacement were exaggerated or imagined. If you have a painful knee replacement 3 months after surgery, you need a few things:

• Evaluation for infection. You need ESR and CRP blood tests taken after you have not had any antibiotics for 2 weeks. Depending on the results, Dr. Maish may need to take a sample of the fluid in your joint.
• A good physical exam. There are problems with hip and knee replacements that can only be detected by examining you.
• A recent X-ray of the painful area.

Even if he can’t figure out what is causing your symptoms, it is important to him to say “I don’t know” rather than making you feel like it is all in your head.

What to expect

Recovery from a revision generally takes longer than recovery from a first knee replacement, and the plan depends on what needs to be fixed. Dr. Maish will tell you plainly what he thinks the problem is, what surgery can and cannot do about it, and what the risks are.

Risks

The risks of revision surgery are higher than for a first knee replacement. Every operation has risks. For joint replacement these include infection, blood clots, stiffness, continued pain, injury to nerves or blood vessels, fracture, and loosening or wear of the implant, any of which could require additional surgery. Dr. Maish spends an hour with you and your family before surgery going through the risks and what you can do to lower them.

Patients who have been through it

Patricia, Sue, Dorothy and Jeff Walter each came to Dr. Maish after a knee replacement that was not working.

If your knee replacement is painful, make an appointment.

This page is general education, not medical advice. Only an examination and a conversation with your surgeon can tell you what is right for you.