Knee replacement revision at Cheltenham Hospital

Reasons for revision of the knee can include:

• Infection
• Loosening of the implant
• Wearing of the implant surfaces
• Bone loss
• Incorrect alignment
  

Your consultant will do a complete examination and may order x-rays, blood tests or an MRI scan to full assess your current implant(s).

If your knee implants have failed your surgeon may recommend revision surgery.

What happens during revision of the knee?

Revision of the knee is usually performed under general anaesthetic. The procedure can take 2 hours depending on the condition of your implants and any bone loss.

Your surgeon will make an incision (cut) down the centre of your knee. Your old implants will be carefully removed. Your surgeon will assess the bone surfaces to confirm if bone grafts might be needed. They will fit your new knee components and adjust any soft tissue, muscles and ligaments around the joint to confirm a good fit both when bending and straightening your leg.

Your soft tissues are sewn back together and the wound will be closed with stitches or staples.

After knee revision

Once your operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic. Your wound, blood pressure and pulse will be checked carefully. You will have a large dressing covering your wound. You may have a small tube coming out of your wound - this is to drain away any excess fluid from the inside of the wound.

You may also have a drip (infusion) going into your arm. This will keep you hydrated until you are able to drink, and can also be used to give you pain relief.

You will need to stay in hospital for several days. Be sure and let us know if you are in pain. You may need to wear compression stockings to prevent blood clots (deep vein thrombosis – DVT).

A physiotherapist will help you get up and begin to move around on your own. They will give you some exercises to help get your knee moving. These are important to help you make a good recovery. The therapist will also show you how to walk up and down stairs and make sure you are confident at doing this before you go home. You won’t be able to drive, so you will need someone to come and take you home from the hospital.

Going home after knee revision

You will go home using crutches or a walker. Be sure and continue to take any pain relief medication as prescribed. Good pain management will help you regain your mobility.

When you get home you will be tired for several weeks and should rest. However, it’s also important to aim to gradually increase your physical activity each day, so you should continue with the exercises the physiotherapist showed you. These will help to reduce stiffness and strengthen your legs. You will need to keep using crutches or a walking stick for a while. To help you manage and increase mobility it’s recommended that you take any pain relief medication we have prescribed. Continue taking this until you are pain free.

Everyone heals differently. You will continue to improve over the next six to twelve months. Your scar should fade to a thin white line.

Depending on what type of job you do, you should be able to return to work within twelve weeks. You may want to think about a phased return to work.

After your follow visit with your surgeon you should be released to drive but only if you can comfortably operate the pedals and control your car in all situations. This includes an emergency stop. If you are in any doubt about your insurance cover, it’s best to contact your insurance company.

Most people make a good recovery and return to normal activities following knee revision. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
• Difficulty passing urine
  

Risks specific to knee replacement surgery are:

• Numbness on the outside of the knee caused by a nerve being cut during surgery
• Stiffness - there may need to be further, minor surgery to improve this
• Pain when kneeling
• Bleeding around the joint - this usually settles but may need to be drained by a surgeon
• Fluid build-up around the joint
• Rejection of the prosthesis
• Infection in the joint
  

Why not print this treatment page so you can discuss any concerns you have with your surgeon?