What is revision knee replacement surgery?

Revision knee replacement is surgery performed to replace or repair part or all of a previous knee replacement that is no longer functioning properly.

It is usually more complex than the first knee replacement because the surgeon may need to remove existing implants, manage bone loss, treat infection, and restore stability.

Why might revision knee replacement be needed?

Common reasons include:

• Implant loosening
• Implant wear
• Infection around the joint replacement
• Knee instability
• Recurrent stiffness
• Fracture around the implant
• Malposition of components
• Persistent symptoms linked to the previous replacement

Before revision surgery is recommended, the cause of the problem needs to be identified carefully.

What tests may be needed?

Evaluation can include:

• X-rays
• Blood tests for infection
• CT or other imaging in selected cases
• Joint aspiration if infection is suspected
• Examination of knee stability and movement

Revision surgery should not normally be undertaken simply because a replaced knee is painful without first identifying the likely reason for that pain.

Why is revision surgery more complex?

Compared with primary knee replacement, revision surgery may involve:

• Removal of old components
• Loss of existing bone
• Scar tissue
• Weaker ligaments
• More complex implants
• Longer operating time
• More demanding rehabilitation

In some situations, revision surgery can be required more than once, but repeat revisions become progressively more complex and depend heavily on bone quality, infection status, implant stability, and general health. ASIC Clinic’s current revision guidance emphasises this individual assessment.

Dr. Atul Mishra evaluates failed or painful knee replacements to determine whether revision surgery is required and what reconstruction strategy is appropriate.