What is Revision Knee Replacement?
Revision knee replacement, also known as revision total knee arthroplasty, is a surgical procedure to remove a previous knee implant and replace it with a new one. This operation is more complex than an initial knee replacement because it often involves repairing or rebuilding bone around the knee joint and ensuring the new implant is securely fixed in place.
In some cases, bone grafts are used to support and stabilise the new implant. These grafts may come from the patient’s own body (autograft) or from a donor (allograft). The goal of the procedure is to restore mobility, relieve pain, and preserve as much healthy bone and tissue as possible.
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Who is Revision Knee Replacement For?
Knee revision surgery is usually considered for patients who have previously had a total knee replacement and are now experiencing pain, instability, or implant failure. It may be recommended when:
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The implant has loosened or worn out over time.
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There is an infection in or around the joint.
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The implant has dislocated or moved out of position.
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There is bone loss or damage due to inflammation or osteolysis.
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Pain and stiffness significantly limit day-to-day activities.
Benefits of Revision Knee Replacement
Pain relief: Removes a loose, damaged, or infected implant to restore comfort.
Mobility: Improves movement and stability, allowing a return to normal daily activities.
Joint protection: Prevents further bone loss and long-term joint damage.
Structural restoration: Rebuilds bone and strengthens the joint with grafts if necessary.
Quality of life: Restores confidence, function, and independence that may have been lost due to a failing implant.
Why Do Knee Replacements Fail?
Knee implants can fail for a few different reasons:
Mechanical wear and loosening:
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The knee joint carries much of the body’s weight. Over time, the metal and plastic components can shift or loosen within the bone, especially if the underlying bone softens or weakens.
Inflammation and osteolysis:
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As the plastic component of the implant wears, tiny particles of debris (polyethylene) can cause inflammation. The body’s immune response to this debris can lead to gradual bone loss — a process known as osteolysis — which eventually loosens the implant.
Infection or dislocation:
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Infected or unstable implants must be replaced to prevent further damage and restore proper knee function.
Risks and Complications
As with any major surgery, revision knee replacement carries certain risks. These may include:
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Infection in the joint or wound.
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Blood clots in the legs or lungs.
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Stiffness or reduced range of motion.
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Continued pain or swelling.
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Bone loss or fracture around the implant.
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Nerve or blood vessel injury (rare).
Because revision surgery is more complex than a first-time knee replacement, recovery may take longer. However, our careful surgical planning and modern techniques help ensure excellent outcomes for most patients.
Before and After Surgery
Before surgery
Patients will have a full medical assessment, including blood tests and imaging scans. Any infections, including dental or urinary infections, must be treated beforehand. The surgeon will discuss your medical history, review current medications, and may advise stopping blood-thinning drugs or certain supplements before surgery.
Surgery
Revision knee surgery generally takes longer than a standard knee replacement — often around three hours. It can be performed under either general or spinal anaesthesia. During the procedure, the old implant and any damaged tissue are removed, and the new prosthesis is fitted. Bone grafts may be used if there is bone loss. Patients typically stay in hospital for three to five days.
Recovery
Rehabilitation begins soon after surgery. Most patients start walking with the help of crutches or a walker within a day or two. Physiotherapy is essential to restore movement and strength.
Some swelling, stiffness, and discomfort are expected for several weeks, improving gradually as healing progresses. Full recovery can take several months, but most patients experience a marked improvement in pain and mobility.
