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Knee Revision Surgery

What is revision total knee replacement? 

Knee replacement revision surgery is a procedure some people may need if they have a knee replacement joint that is damaged or diseased. With total knee replacement (TKR), or knee arthroplasty, most people have good results and enjoy many years of function from their prosthetic joint. But what happens when a knee replacement wears out? Sometimes, these replacement joints fail. In that case, they need revision total knee replacement, a more complex procedure, to replace them.

Ready to explore your options? Contact Banner Health to schedule a consultation with one of our experienced orthopedic surgeons today.

Common reasons for revision total knee replacement

You may need to have total knee replacement revision surgery if you had a knee replacement in the past and you have:

  • Knee pain, swelling or stiffness
  • Instability
  • A loose or worn implant
  • Infection in the implant area
  • Fracture, often caused by a fall

Why choose Banner Health for complex knee revision surgery?

At Banner Health, our orthopedic surgeons specialize in complex knee revision surgeries, using advanced techniques and state-of-the-art facilities to deliver exceptional care. Our team prioritizes your comfort and recovery every step of the way, ensuring you have a personalized care plan designed to meet your unique needs.

How revision knee surgery differs from primary knee replacement

In total knee replacement surgery, a doctor replaces a diseased or damaged knee joint with a prosthesis. In knee replacement revision surgery, some or all of the components of that prosthesis need to be replaced. There may be damage to your bone and the surrounding tissue near your original implant due to wear and tear, requiring specialized implants during revision surgery.

Wondering what makes revision surgery different? Learn more by connecting with one of our specialists.

Preparing for knee revision surgery

A few weeks before your surgery, you’ll have a physical exam to make sure you don’t have any conditions that would affect your success with surgery or recovery. If you have any chronic conditions, such as heart disease, you may also need to see those specialists.

Because revision surgery is more complex than the original procedure, you may need more recovery time and more help after surgery while recovering. Depending on your condition, you may need to stay at a nursing home or rehabilitation center after surgery. And you will want to make arrangements to have someone help you at home with cooking, shopping, bathing and household tasks during your knee revision replacement recovery time.

Imaging and diagnostic tests before knee revision surgery

Your doctor will likely recommend imaging tests to evaluate the condition of your knee. Those could include X-rays, nuclear medicine bone scans, MRIs and/or CT scans. Blood tests can identify infections in your knee. And if your doctor suspects an infection, they may remove some fluid from your knee joint so it can be analyzed.

Your surgeon will evaluate these tests to determine which components will likely need replacing. However, the final decision on all components replaced is made during surgery. Learn more about the imaging and diagnostic services available at Banner Health.

What to expect during knee revision surgery

Knee revision surgery is a more complex procedure than primary knee replacement. It typically takes longer and requires specialized tools and surgical expertise. You’ll receive general anesthesia for the procedure. 

Your surgeon will make an incision over your knee and gently move your kneecap and tendons to the side to access the joint. This incision is often longer than the one used for your original knee surgery to allow enough space to safely remove the old knee implant. The surgeon will assess the condition of the components and check for signs of infection, wear and tear, and tissue damage. 

Managing excessive scar tissue and soft tissue during surgery 

Excessive scar tissue and damaged soft tissue are common challenges in revision total knee replacement. These issues can limit your range of motion and make the joint feel stiff. Your surgeon may need to carefully remove or release scar tissue and adjust or repair surrounding soft tissue to improve joint stability and help restore your mobility. These steps are critical to ensure a successful outcome from your knee revision surgery. 

Inserting the new knee implants and bone grafts 

Once the original implant is removed and the knee joint is evaluated, your surgeon will rebuild the area as needed. If you’ve lost bone due to loosening, fracture or infection, they may use a bone graft or metal spacers to fill the gaps and provide a solid foundation. Then, the new knee implants - including the femoral, tibial and possibly patellar components - will be positioned and secured in place. 

To finish the surgical procedure, your surgeon may place a drain to remove fluid and blood from the area, and then carefully close the incision. 

Risks and complications of knee revision surgery

All major surgical procedures have risks. These risks are typically the same ones you talked about with your surgeon with your first surgery. However, the complexity of the procedure may increase the potential risk. Possible knee revision surgery complications include:

  • Poor healing
  • Infection
  • Stiffness or reduced range of motion (sometimes caused by scar tissue buildup around the joint)
  • Bleeding
  • Fracture
  • Damage to nerves or blood vessel injury
  • Blood clots in the legs or lungs
  • Heart attack, stroke or lung problems

Have questions about your risks? Our team is here to address your concerns and guide you through the process.

Recovering after knee revision surgery

Your doctor will give you detailed instructions for caring for your new knee joint once you're home. Following these instructions closely is key to preventing complications and getting back to your daily routine. 

Home recovery tips for your revised knee joint 

You may need to use a walker or crutches at first to help with balance and mobility. Your health care team will show you how to bandage and care for your surgical wound. Avoid soaking the area in water until it’s fully healed. Stitches or staples are typically removed about two weeks after surgery. 

Banner Health offers outpatient physical therapy and rehabilitation programs to help restore range of motion and build strength. You’ll continue therapy both at home and with a licensed physical therapist - likely for up to three months. These exercises are important to relieve pain, reduce stiffness and prevent excessive scar tissue from forming. 

You may be asked to limit how much weight you put on your knee or how far you bend it until healing progresses. Over time, your goal is to fully straighten your leg and bend it at least 90 degrees. 

Typical recovery timeline for knee revision surgery 

Recovery after revision total knee replacement can take longer than recovery after primary knee replacement. Most people can return to basic activities and work within three to six months. Full recovery - including strenuous activity and exercise - can take up to 12 months. 

Although some people may continue to experience mild stiffness or discomfort, most see significant improvement in joint stability and daily function. 

Long-term outcomes

Although some people may still have some pain, stiffness and reduced function even after recovering from surgery, most people have good outcomes after revision joint replacement. They have less pain and more joint stability and can function better. 

Frequently asked questions about knee revision surgery

What is the difference between primary knee replacement and revision knee surgery?

Primary knee replacement is your first surgery to replace a damaged knee joint. A revision total knee replacement is done when the first implant wears out, loosens or fails. Revision surgery is a complex procedure that requires advanced techniques and may involve bone grafts or specialized knee implants.

Why would I need revision knee surgery?

You may need revision surgery if your original knee replacement has failed due to wear and tear, infection, loosening, fracture or instability. Signs may include ongoing pain, swelling or limited movement. Some people also require revision surgery because of issues with soft tissue or excessive scar tissue.

How long does recovery take after knee revision surgery?

Most people recover enough to return to regular daily activities within 3 to 6 months, but full recovery - including exercise and strenuous tasks - may take up to 12 months. You’ll need physical therapy to improve range of motion and strength.

Will I need a bone graft during revision surgery?

Sometimes. If bone has been lost due to infection or implant loosening, your surgeon may use a bone graft or metal augmentation to rebuild the joint and properly fit your new knee implant.

Is knee revision surgery more painful than the first surgery?

Recovery can be more challenging after a revision because the surgical procedure is typically more complex. However, with good pain management and physical therapy, most people find they can successfully relieve pain and regain function over time.

What are the risks of revision total knee replacement?

As with any surgical procedure, there are risks. These include infection, blood clots, poor wound healing, reduced range of motion or damage to nerves or blood vessels. Your care team at Banner Health will monitor you closely to reduce these risks.

Can I have more than one knee revision surgery?

Yes, but it depends on your overall health, bone quality and the condition of your knee joint. While many people do well after a single revision total knee replacement, some may eventually need another surgery if complications occur or the implant fails again. 

However, each additional surgery can be more complex and may involve further bone grafting or soft tissue reconstruction. Your orthopedic surgeon at Banner Health will help you understand your options and risks.

Ready to relieve your knee pain? Find expert care at Banner Health

If you're still dealing with pain or problems from a previous knee replacement surgery, you don't have to manage it alone. The orthopedic experts at Banner Health specialize in revision total knee replacement - a complex procedure that requires advanced training, experience and technology.

We’ll work with you to create a personalized plan that helps restore your movement, reduce your pain and get you back to doing what you love.

Schedule a consultation with one of our skilled orthopedic surgeons today to explore your options and take the next step toward lasting relief.

Find a knee specialist near you.