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Revision Knee Replacement Surgery in Pune

Improve Knee Function With Our Expert Orthopaedic Surgeons

Revision total knee replacement surgery, often referred to simply as knee revision surgery, is a complex orthopaedic procedure performed when a previously implanted artificial knee joint from an initial total knee replacement (TKR) fails to function correctly or becomes problematic due to factors like wear, infection, instability, or any other complications.

During this surgery, the original knee prosthesis is removed, and any damaged or compromised bone tissue is addressed, often with the use of augments and cones. Subsequently, specialised revision knee implants are carefully inserted to replace the failed components. This intricate surgical intervention requires thorough planning and surgical expertise to achieve successful outcomes and provide patients with pain relief and improved knee function after the failure of their initial knee replacement.

When Surgery is Recommended

Revision knee replacement surgery is recommended when a primary knee replacement has failed or is causing significant issues that cannot be effectively managed through non-surgical means. Some common situations that may lead to the recommendation of revision knee replacement surgery include:


Implant Failure: When the original knee implant starts to loosen, wear out, or become infected, revision surgery is often necessary to replace the damaged components.



Persistent Pain: If a patient experiences persistent and severe pain in the knee joint after the initial knee replacement, despite non-surgical interventions, revision surgery may be considered to address the underlying cause. Particularly of malalignment is the cause for pain


Infection: In cases of deep infection around the knee joint, revision surgery may be required to remove and replace the infected components with new, sterile implants. Typically it is done as a two stage procedure.


Instability: When the knee joint becomes unstable due to ligament laxity or improper implant positioning, revision surgery can help restore stability and function.


Fractures: Periprosthetic fractures (fractures around the knee implant) that affect the stability or fixation of the implant may necessitate revision surgery.


Limited Range of Motion: If excessive scar tissue forms around the knee joint, restricting its range of motion and daily activities, revision surgery may be considered to improve mobility.


Preoperative Assessment

Before surgery, the patient undergoes a comprehensive assessment. This evaluation comprises a clinical examination and various diagnostic procedures, such as X-rays, CT scans, or MRI scans, to determine the extent of damage to the knee implant and potential bone loss. In cases where infection is a concern, a joint fluid aspiration may also be conducted to identify the type of infection present. These preoperative assessments provide crucial information that guides the surgical approach and helps ensure the most effective treatment for the patient.

Surgical Procedure

During the surgical procedure, the patient is typically administered regional anaesthesia (spinal or epidural) to numb the lower body while maintaining wakefulness. A surgical incision is made over the knee joint to access it. The old knee implant and any compromised or infected tissue are meticulously removed, occasionally necessitating comes and augments  to address voids or bone loss. The remaining bone surfaces are then prepared by the surgeon, removing any damaged or unhealthy bone. Specialised revision knee implants, designed to tackle the specific challenges of revision surgery, such as bone loss and alignment issues, are subsequently inserted. Finally, the surgeon closes the incision using sutures or staples.

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Physiotherapy

Post-operative Care

Effective post-surgery care is vital for a successful recovery process. Following these key recommendations can significantly contribute to a smoother recovery:

  • Make use of a walker to assist with moving around. This aids in maintaining stability and preventing unnecessary strain on the healing knee.

  • Regularly perform exercises as instructed by the physiotherapist. These exercises are tailored to enhance strength, flexibility, and overall knee function.

  • Apply cold therapy as advised to reduce swelling and manage discomfort. Cold packs can be beneficial in easing post-surgery inflammation.

  • Adhere to the recommended diet plan, which can support the healing process and provide essential nutrients for recovery.

  • Ensure sufficient rest to allow your body to heal. Also, maintain scheduled follow-up appointments with your surgeon to monitor progress and address concerns.

FAQ'S

1. What is knee arthroscopy, and when is it recommended?

Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat various knee conditions. It's recommended when conservative treatments like rest, physical therapy, or medication fail to provide relief from knee pain or when there's a need for a precise diagnosis of unexplained knee symptoms.

2. What are the common knee issues treated with arthroscopy?

Knee arthroscopy can address a range of knee problems, including torn meniscus, ligament injuries like ACL or PCL tears, inflammation of the synovium, cartilage damage, loose fragments in the joint, and patella-related issues.

3. What can I expect during the recovery period after knee arthroscopy?

Recovery from knee arthroscopy involves rest, keeping weight off the knee, and possibly using crutches or a walker. Elevating the leg to reduce swelling is crucial. Patients are typically advised to follow a physiotherapy program to regain full mobility and function gradually.

4. How long does knee arthroscopy surgery typically take?

The duration of knee arthroscopy can vary depending on the complexity of the issue being addressed. On average, the procedure takes about 30 minutes to an hour. However, your orthopaedic surgeon will provide you with a more accurate estimate based on your specific case and number of ligament repaired or reconstructed .

5. Is knee arthroscopy an outpatient procedure?

Yes, knee arthroscopy is often performed as an outpatient procedure, meaning you can typically go home on the same day as your surgery. However, the exact discharge plan may vary based on your surgeon's recommendation and your overall health.

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