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Revision Joint Replacement - What All It Can Fix?

Written and reviewed by
Dr. Karan Kishore Mane 88% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, Diploma in Spine & Reconstruction, Fellowship In Primary Joint Replacement, Fellowship in Arthroplasty and Reconstructive Orthopaedic Surgery, Fellowship in Revision Hip Surgery & Adult Reconstruction
Orthopedist, Nagpur  •  8 years experience
Revision Joint Replacement - What All It Can Fix?

A joint replacement is mostly a successful procedure, be it a Knee Replacement or a Hip Replacement. People can lead active lives after a Joint Replacement Surgery. However, prolonged use may result in wear and tear or loosening of the prosthesis. In that scenario, one may experience pain and discomfort and face difficulty in daily activities. Under such circumstances, doctors may recommend a revised joint replacement.

Both primary joint replacement and revision joint replacement have the same goal and that is to relieve pain and improve the functioning of the joints. However, revision surgery is often more detailed and difficult, compared to primary Joint Replacement.

It is a longer procedure requiring extensive planning, specialized implants as well as specialized tools.

Circumstances That Necessitate a Revision Total Knee Replacement

Apart from the prosthesis becoming loose or wearing out, there may be other circumstances when a Revision Total Joint Replacement may be needed. Some of the common scenarios in which the doctor might recommend going for Revision Knee Replacement are listed below:

Infection

infection cannot be ruled out in any surgical procedure, let alone joint replacement procedures. Infections may occur in hospitals, at home or even years later. If an implant is infected, it becomes painful and stiff. When this happens, the implant may come off its attachment to the bone. There may be drainage due to the infection and the person is very likely to feel pain and swelling. Such conditions most often require revision joint replacement.

Instability

If ligaments around the joint have been damaged, the joint itself may become unstable. A prosthesis is implanted in such a way that it is in balance with existing ligaments. If there is any change in the ligaments, the prosthesis may not work. One may have the feeling of the knee giving way.

Stiffness

Improper surgery may result in excessive formation of scar tissue around the joint. Doctors may attempt manipulation under anaesthesia. However, if this does not work, the person may need a revision procedure.

Fractures

A bone around the prosthesis may break. Such fractures most often result from a fall and very likely to require revision surgery.

Specialized Procedure

In a revision procedure, the doctor may revise the whole implant or a component of the implant. In a knee replacement, there are three components - tibial, femoral and patellar. If the doctor deems fit, he may replace all three components and also rebuild the bone around the joint to substitute for bone grafts or missing bones. If there is extensive damage to the bone, the doctor may have to use specialized implants. These implants have thicker and longer stems that go deep inside the bones and provide extra support.

Conclusion

If the person is feeling pain and discomfort along with difficulty in daily activities for some time, he/she needs to visit the doctor and may need a Revision Joint Replacement. Depending on the individual condition, it may need a full replacement or partial replacement.

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