Overview of Revision Knee Replacement Surgery Treatment

Revision total knee replacement which is also known as revision TKR, is a surgical procedure performed to replace a previously implanted artificial knee joint that has failed or become damaged due to any issue. It is typically required when a primary total knee replacement has not achieved the desired outcome or when the artificial knee joint has become damaged over time. Recovery from revision Total Knee Replacement is usually more challenging than recovery from primary Total Knee Replacement because revision total knee replacement is a very complex procedure. There may be more extensive tissue damage and may require more time for the healing process to complete. In some cases, all the components of the implant are replaced with new components and sometimes few components changed according to the condition of primary total knee replacement. Revision total knee replacement has some risk factors that can delay the recovery time. For example, it is essential to take the medications that prevent the blood clot formation after the surgery. Physical therapy is an essential part of the recovery process and helps regain strength, mobility, and function in the knee joint. Most of the patients who receive revision total knee replacement experiences long term effects of the procedure. But in some cases there may be the presence of pain and limited joint mobility which affects the overall quality of life. 

Types of Revision Knee Replacement Surgery Treatment

There are different types of revision total knee replacements, depending on the specific needs of the patient and the extent of the damage of previous knee replacement. Here are some common types:

  • Partial revision
  • Complete revision
  • Component exchange
  • Two stage revision
  • Complex revision

Partial Revision

In some cases, only a portion of the knee prosthesis needs to be changed, such as the shin bone component or the thigh bone component. This type of revision involves replacing the affected component while leaving the remaining components intact.

Complete Revision

A complete revision involves removing and replacing all components of the knee prosthesis. This is typically done when there is extensive damage, loosening, or failure of the previous prosthesis.

Component Exchange

In this procedure only one component of the knee prosthesis is exchanged. If there is a problem with the plastic spacer between the metal components it can be replaced without removing the entire prosthesis. And if there is a problem with the metal component, it can be removed without removing the plastic spacer between them.

Two-Stage Revision

This type of revision is performed when there is an infection in the knee joint. In a two-stage revision, the infected prosthesis is removed and after deep cleaning a temporary antibiotic spacer is inserted. Then a new prosthesis is implanted after a period of several weeks or months.

Complex Revision

Complex revision total knee replacement is required when there are multiple issues with the knee joint, such as severe bone loss, fractures, or failed previous revision surgeries. These cases often involve a complex procedure and may require additional techniques like bone grafting or the use of specialized implants.


Procedure of Revision Total Knee Replacement

The general explanation of the Revision Total Knee Replacement procedure is as follow:

Pre-operative assessment: the general assessment of the patient is performed to check the condition of bone, prosthesis and surrounding soft tissues. This may include x-rays, medical histories and the patient's general health. The doctors also decide the type of procedure which should be performed.

Anesthesia: the incision is made when a patient is under the effect of anesthesia because it reduces the pain and numbs the area under procedure, which makes it less irritating for the patient.

Removing the previous prosthesis: The surgeon removes the previous components of the knee prosthesis. This may involve separating the components from the bone and removing cement or dead areas of the bone.

Implanting the new prosthesis: The new components of the knee prosthesis are placed into the bone surfaces. The components may include a thigh bone metal component, a metal or plastic shin bone component, and a plastic spacer which is placed between them.

Closure: the surgeon closes the incision with sutures and applies medicines which prevent the infections. A partial drainage bag may also be attached to drain the fluid.

Post-operative plan of care: the medications to prevent infections, blood clot formations and painkillers are the part of post-operative care. Physical therapy is necessary to speed up the recovery and restore the joint motion and strength.

It's important to note that the specific details of the procedure may vary based on individual patient factors and the skill of the surgeon.

Cost of Revision Total Knee Replacement in India

The cost of revision knee replacement surgery in India can vary depending on several factors such as the city where the procedure is performed, the hospital, the skill of a surgeon, the type of implant used, and other medical facilities. However, the cost of revision knee replacement in India can range from approximately 6,000 to 7,700 USD or more. The cost may vary according to cities of India also. Some of them are mentioned below:

Cost of revision total knee replacement in different cities of India:

Treatment Cities in India Min in USD Max in USD
Bangalore 3857 USD 4678 USD
Mumbai 4397 USD 5122 USD
New Delhi 4320 USD 4980 USD
Hyderabad 4089 USD 4889 USD
Chennai 4166 USD 5001 USD
Kolkata 4629 USD 6509 USD
Ahmedabad 4166 USD 5001 USD
Kochi 4629 USD 5388 USD
Lucknow 4166 USD 4988 USD
Chandigarh 4320 USD 6012 USD

 

Symptoms & Risk Factors of Revision Knee Replacement Surgery

Indications of Revision Total Knee Replacement:

  • Aseptic loosening
  • Infection
  • Fractures
  • Implant wear and tear
  • Implant failure or breakage
  • Extensive bone loss
  • Bone loss
  • Patellar tendon rupture
  • Component instability or dislocation
  • Fracture of the implant or surrounding bone
  • Ligamentous instability
  • Component damage
  • Joint stiffness
  • Patellar instability
  • Implant allergy

Risk Factors of Revision Total Knee Replacement

Although Revision Total knee replacement is a very effective procedure it is associated with serious risks if not handled properly. Some of the risk factors are:

Implant Problems

The artificial knee joint can wear out or fail over time, which may require the revision surgery for total knee replacement.

Infection

Infections can occur after the initial knee replacement surgery or it may appear late. In both cases the infection can spread to the whole body if not properly handled.

Fractures

Sometimes fractures may appear around the knee joint. It can happen due to injury or stress on the implant which then further requires a revision surgery.

Loosening

The implant components may become loose over time, causing pain and instability and require proper care after transplant procedure.

Kneecap Issues

Problems with the kneecap, such as dislocation or wear, may result in the limited activity and may restrict the patient to participate in daily activities.

Bone Loss and Fractures

Severe bone loss or fractures around the knee can compromise the implant's stability, which can cause further complications.

Improper Component Placement

If the implant components were not positioned correctly during the initial surgery, they may damage the tissue around the implant and cause severe complications.

Top Hospitals for Revision Total Knee Replacement in India

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Max Multi Speciality Centre Noida Noida,India

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Fortis Escorts Hospital, Amritsar Amritsar,India

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Fortis Escorts Hospital, Jaipur Jaipur,India

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Max Super Speciality Hospital Dehradun Dehradun,India

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Max Super Speciality Hospital, Bathinda Bathinda,India

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Top Doctors for Revision Total Knee Replacement in India

Empower your Health with the Expertise of Leading Medical Professionals.

Dr I.P.S Oberoi

Department of Orthopedics

Head

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Dr. Bhushan Nariani

Department of Orthopedics

Senior Director Joint Replacement

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Dr Krishnamoorthy K

Department of Orthopedics

Consultant

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Dr. Praveen Kumar K

Department of Orthopedics

Consultant

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Dr Uma Chandran S

Department of Orthopedics

Consultant

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Treatment Costs for Revision Total Knee Replacement

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FAQ's of Revision Knee Replacement Surgery Treatment

As mentioned above the risks associated with the revision surgery are more as compared to the primary knee replacement. Some of the common risks and complications associated with surgery are Bleeding, Infection, Drainage of fluids from the wound, Damage to the surrounding nerves or blood vessels, Fracture during the surgery and Blood clotting

Usually, regional anaesthesia is used for revision knee replacement. This includes, Spinal block - The anaesthetic medication is injected into the Cerebro-Spinal fluid present around the spinal cord. This causes numbness in the lower part of the body. Epidural block - This type of anaesthesia is administered by using a catheter in the lower back to deliver the medication at a variable time period. Peripheral nerve block - This is a type of local anaesthesia that is administered in one of the major nerves in the thigh. This causes numbness only in one leg if a single knee replacement is needed.

Some of the common recommendations given by the knee transplant surgeons after the revision knee surgery are: start walking with the help of a walker or a stick and try to put weight on your leg as per your comfort, use ice packs 3-4 times a day to reduce pain and swelling after the surgery, make sure the incision does not get wet, Keep the incision clean and dry, if you notice any drainage or redness around the incision, or you get a fever, report your doctor urgently and avoid taking shower until the sutures are removed.

The knee revision surgery alternatives are rarely used, and sometimes may have worse implications. These alternatives include Arthrodesis that is the fusion of the knee joint in a non-bending position, and Amputation which means the severely infected knee joint is taken out completely. If you have been recommended to get the revision knee replacement, you must consult Ortil Health. Ortil is an online platform to facilitate your journey and assist you with everything during your treatment. The motive is to make your medical trip smooth and pleasant.