Revision Total Knee Replacement

Orthopaedic Surgeon of South Australia – Dr Chien-Wen Liew

A total knee replacement is a successful operation. Current literature suggests that 80% of total knee replacements are successful, meaning that a patient is either “good” or “excellent”. This means that 20% of patients are not happy for multiple reasons. There are significant reasons why a knee may not function correctly after a total knee replacement. This can be due to loosening of the component over time, implant failure, infection, or instability. There are many other causes and as a knee replacement is like any other bearing surface, it can wear out.

A total knee replacement which requires revision is often performed because something has happened to the original implant or bone and the knee is not functioning correctly. When a decision has been made to change the implant, it is often necessary to put a more “sturdy” implant in its place. This takes over some of the work off the ligaments and bone, and allows for the implant to be more reliable.

The results of a revision total knee replacement are not quite as good as a primary total knee replacement. This can be due to the soft tissue damage that occurs during total knee replacements. Re-operating in the same area can cause more scar tissue, meaning that range of movement may not be as good as it was before.

A revision total knee replacement requires a specific approach to ensure that the correct operation is performed. This includes selecting what parts of the knee need to be changed, and what the operation will involve. For infections, this sometimes involves multiple operations in order to rid the knee of infection, along with a long term dose of intravenous antibiotics.

As each case is so different, it requires an approach tailored to each patient’s knee and medical history. When seeing your orthopaedic surgeon regarding your total knee replacement, it is important to ensure that you have information about where your knee was put in, who performed the original surgery, when it started to feel different, and whether there were any episodes of suspected infection in the knee. Often new X-rays, or CT scans are ordered, along with blood tests to check for markers of infection and to check alignment.

To discuss the function of your total knee replacement, please contact Dr Chien-Wen Liew at his office, to make an appointment. (08) 7099 0188 or use the contact form on this website.

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