Revision Knee Replacement
Knee Revision Surgeon in Colorado Springs, CO
Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and may require revision surgery. Michael Van Manen, Do provides diagnosis and individualized non-operative and operative treatment plans in Colorado Springs, CO. Michael Van Manen, Do also provides highly specialized care during and after the surgery. Contact Michael Van Manen, Do’s office for an appointment today!
Revision knee replacement is a complex orthopaedic procedure used to repair or replace a previous knee replacement when the original implant has become painful, unstable, worn, loose, infected, or otherwise unable to function properly. For patients experiencing persistent knee pain or problems after a previous knee replacement, revision knee replacement in Colorado Springs may help address the underlying cause and restore stability and function.
Michael Van Manen, DO provides evaluation and treatment for knee conditions, including knee replacement and revision surgery. As a board-certified orthopaedic surgeon with experience in arthritis disease management, total knee replacement, trauma and fracture care, and revision surgery, Dr. Van Manen evaluates each patient's symptoms, previous knee replacement, imaging findings, and overall joint condition when developing an appropriate treatment plan.
What is Revision Knee Replacement?
Revision knee replacement surgery involves replacing a part or all your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and may require a second revision surgery.
What is Arthritis?
The knee joints are lined by soft articular cartilage that cushion the joints and aid in smooth movement of the joint bones. Degeneration of the cartilage due to wear and tear leads to arthritis, which is characterized by severe pain.
What is Total Knee Replacement?
During total knee replacement, the damaged cartilage and bone is removed from the knee joint and replaced with artificial components. Artificial knee joints are usually made of metal, ceramic or plastic, and consist of the femoral and the tibial components.
What are the Indications for Revision Knee Replacement?
Revision knee replacement surgery may be advised if you have one or more of the following conditions:
- Trauma to the knee joint
- Chronic progressive joint disease
- Increased pain in the affected knee
- Worn out prosthesis
- Knee instability or a feeling of giving way while walking
- Loosening of the prosthesis
- Infection in the prosthetic joint
- Weakening of bone around the knee replacement - a process known as osteolysis (bone loss)
- Stiffness in the knee
- Fracture
What is the Procedure for Revision Knee Replacement?
Revision knee replacement surgery may involve the replacement of one or all the components.
The surgery is performed under general anesthesia. Your surgeon makes an incision over your knee to expose the knee joint. The kneecap along with its ligament may be moved aside so that there is enough room to perform the operation. Then, the old femoral component of the knee prosthesis is removed. The femur is prepared to receive the new component. In some cases, the damaged bone is removed and bone graft or a metal wedge may be used to make up for the lost bone.
Next, the tibial component along with the old plastic liner is removed. The damaged bone is cut and the tibia is prepared to receive the new component. Like the femur, the lost bone is replaced either by a metal wedge or bone graft. Then, a new tibial component is secured to the end of the bone using bone cement. A new plastic liner will be placed on top of the tibial component. If the patella (kneecap) has been damaged, your surgeon will resurface and attach a plastic component. The tibial and femoral components of the prosthesis are then brought together to form the new knee joint, and the knee muscles and tendons are reattached. Surgical drains are placed for the excess blood to drain out and the incision is closed.
What are the Risks and Complications of Revision Knee Replacement?
Like all major surgical procedures, there may be certain risks and complications involved with revision knee replacement surgery. The possible complications after revision knee replacement include:
- Stiffness in the knee
- Infection
- Bleeding
- Formation of blood clots in the leg veins
- Injury to nerves or blood vessels
- Prosthesis failure
- Patella (kneecap) dislocation
- Ligament injuries
What Does Postoperative Care for Revision Knee Replacement Involve?
Following revision knee replacement surgery, a continuous passive motion (CPM) machine may be used to allow your knee joint to slowly move. The machine, attached to the treated leg, slowly moves the joint through a controlled range of motion, while you are at rest.
You can walk with crutches or a walker. You will be sent for rehabilitation within a couple of days of surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore range of motion to the knee. Your physical therapist will also provide you with a home exercise program to strengthen the thigh and calf muscles.
Knee immobilizers are used when performing physical therapy, walking and while sleeping to keep the knee stabilized.
Why Choose Dr. Michael Van Manen, DO for Revision Knee Replacement in Colorado Springs?
Revision knee replacement requires careful evaluation because problems with a previous knee replacement can have several possible causes, including implant wear or loosening, infection, instability, bone loss, fracture, or progressive joint problems. Dr. Michael Van Manen, DO, is a board-certified orthopaedic surgeon serving patients in Colorado Springs and has a practice focus that includes knee replacement, revision surgery, fracture care, and arthritis disease management.
Dr. Van Manen takes an individualized approach to evaluating patients with painful or problematic knee replacements. His assessment may include a review of your previous surgery and medical history, physical examination, imaging, and other testing when appropriate to determine why the knee replacement is causing symptoms.
Benefits of working with an orthopaedic surgeon may include:
- Evaluation of persistent or worsening pain after knee replacement
- Assessment of knee stability and range of motion
- Review of the condition and positioning of existing implant components
- Evaluation for possible implant loosening, wear, bone loss, fracture, or infection
- Discussion of nonsurgical and surgical treatment options
- Individualized planning when revision surgery is appropriate
- Guidance regarding rehabilitation and recovery following surgery
Whether you need evaluation for a painful knee replacement or are considering revision surgery, comprehensive orthopaedic care can help you understand the condition of your knee and make an informed decision about treatment.
Revision Knee Replacement FAQs
What is revision knee replacement?
Revision knee replacement is a surgical procedure performed to repair or replace some or all components of a previous knee replacement. The extent of revision depends on the reason the original implant is no longer functioning properly and the condition of the surrounding bone and soft tissues.
Why might a knee replacement need revision surgery?
A knee replacement may require revision because of implant loosening or wear, infection, instability, fracture, significant bone loss, persistent pain, stiffness, or other problems affecting the function of the artificial joint.
Does persistent pain always mean my knee replacement has failed?
No. Pain after knee replacement can have several causes and does not automatically mean the implant has failed. An orthopaedic evaluation is important to determine the underlying cause before deciding whether revision surgery is necessary.
What are the signs that a knee replacement may need revision?
Possible signs include increasing or persistent pain, swelling, instability or a feeling that the knee is giving way, stiffness, decreased function, changes following an injury, or other new symptoms involving the replaced knee.
How is a failed knee replacement diagnosed?
Your surgeon may review your medical and surgical history and perform a physical examination. X-rays and other imaging studies may be used to evaluate the implant and surrounding bone. Additional tests may be recommended when infection or another specific problem is suspected.
What happens during revision knee replacement surgery?
Revision surgery may involve replacing one or more components of the existing knee prosthesis. Depending on the condition of the bone and soft tissues, additional procedures may be needed to address bone loss, instability, or other problems.
Is revision knee replacement more complicated than the original replacement?
Revision surgery can be more complex than a primary knee replacement because the surgeon may need to remove existing components and address changes to the bone or soft tissues. The complexity varies depending on why the original replacement failed and how much reconstruction is required.
What are the risks of revision knee replacement?
As with any major surgery, revision knee replacement carries potential risks. These can include infection, bleeding, blood clots, stiffness, nerve or blood vessel injury, instability, implant failure, fracture, and the possibility of requiring additional surgery.
How long does recovery take after revision knee replacement?
Recovery varies based on the extent of the revision, the patient's overall health, the condition of the knee, and other factors. Rehabilitation typically focuses on gradually restoring strength, mobility, stability, and function according to the surgeon's postoperative plan.
Will I need physical therapy after revision knee replacement?
Many patients participate in physical therapy following revision knee replacement. A rehabilitation program may include exercises designed to improve knee motion, strengthen the muscles around the knee, improve walking ability, and support a safe return to daily activities.
Can all of the knee replacement components be replaced?
Not necessarily. Depending on the cause of the problem and the condition of the existing components, revision surgery may involve replacing only certain components or revising the entire knee replacement.
Can infection cause a knee replacement to fail?
Yes. Infection involving a knee prosthesis is a serious potential complication and can affect the stability and function of the implant. When infection is suspected, additional evaluation and treatment are necessary before determining the appropriate surgical approach.
What is bone loss after knee replacement?
Bone loss, sometimes called osteolysis in the setting of implant-related wear, can occur around a knee replacement and may affect the stability of the prosthesis. The amount and location of bone loss can influence revision surgery planning.
When should I see an orthopaedic surgeon about a painful knee replacement?
If you develop persistent or increasing pain, swelling, instability, stiffness, reduced mobility, or other concerning symptoms after knee replacement, an orthopaedic evaluation can help determine the cause. New symptoms following an injury should also be evaluated promptly.
Schedule a Revision Knee Replacement Consultation in Colorado Springs
If your knee replacement has become painful, unstable, stiff, or difficult to use, you may benefit from an evaluation by an experienced orthopaedic surgeon. Identifying the cause of your symptoms is an important first step in determining whether nonsurgical treatment, revision of part of the implant, or more extensive revision knee replacement is appropriate.
Contact Dr. Michael Van Manen, DO, in Colorado Springs, Colorado, to discuss problems with a previous knee replacement and learn more about your treatment options. A personalized evaluation can help you understand the condition of your knee and develop an appropriate plan for improving mobility and function.
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