Revision surgery after knee replacement

A total knee replacement is one of the most successful procedures in modern medicine. Many of today’s knee implants are still designed to last for many years. However, some of these devices may still fail over time due to several reasons.

When this happens, patients may experience significant pain. Their knee area could also become swollen and stiff, making everyday activities more difficult to perform. In this case, a doctor may suggest a knee revision surgery.

A revision surgery, however, is a more complicated and longer procedure than primary total knee replacement. It also requires mastery of difficult surgical techniques to achieve a good result. Unfortunately, certain people are being exposed to the risk of undergoing a knee replacement revision surgery, including patients who received the recently recalled Exactech knee, ankle, and hip implants.

According to Exactech, thousands of their knee and ankle implants manufactured since 2004 have polyethylene plastic inserts that were defectively packaged in “out-of-specification” vacuum bags. This defect could expose the inserts to oxygen, causing severe degradation to the liners.

Potential injuries people with the recalled knee and ankle liners could experience include early failure, component fracture, and bone loss, which could all result in revision surgery. Resulting complications have led victims to file an Exactech lawsuit in the United States. Plaintiffs allege that the company knew about the defective devices but never warned them or their surgeons.

Now more than ever, it is important to be well-informed about major operations such as a knee surgery. Read on to learn more about what revision knee replacement procedure is, who needs it, and its potential risks and complications.

What is a knee replacement revision surgery?

A knee replacement revision surgery is the replacement of a failed knee implant with a new prosthesis. In this reoperation, a surgeon replaces a certain part or all components of a patient’s previous knee prosthesis with a new one.

When a complete exchange of all the components is involved, this surgery is known as a revision total knee replacement. It is a complex procedure that makes use of specialized tools and additional preoperative planning.

When would I need revision knee replacement surgery?

A patient would need revision knee replacement surgery due to the following reasons:

  • Infection
  • Instability
  • Stiffness
  • Trauma or fracture
  • Implant loosening


Infection is a possible risk from any surgery, including a total knee replacement. An infection can develop while in the hospital, soon after the procedure, or even years later. Although rare, when infections occur, revision can be done in two ways: debridement and staged surgery.

Debridement is a surgical washout of the joint, where bacteria is washed out and plastic liners or spacers can be exchanged while leaving the metal implants in place.

On the other hand, in staged surgery, the implant is completely removed and replaced. This procedure involves a series of surgeries and is necessary if the infection has occurred months or years following the initial knee replacement.


Instability after total knee arthroplasty is a common cause of early component failure and revision surgery. This occurs when ligaments around the knee become damaged. Changes in these ligaments are what prevent an implant from working properly. As a result, they fail to provide the stability needed for everyday activities like standing or walking. This complication may also cause recurrent swelling in patients.

In certain cases, instability can be treated through nonsurgical means, such as physical therapy and bracing. Otherwise, revision surgery may be necessary.


In some cases, excessive scar tissue can form around a joint after a knee surgery. This can limit range of motion as well as cause pain and disability. Some known contributing factors include bleeding and infection.

To treat stiffness, the doctor may put a patient under anesthesia and bend their knee to break up scar tissue. This procedure is successful in improving range of motion in most cases. However, other times, revision surgery may be needed if there is excessive scarring.

Trauma or fracture

A periprosthetic knee fracture is a break fo the bone above or around the components of a total knee replacement. These fractures may occur as a result of trauma or fall after the surgery and may also happen without any history of trauma or fall and stem from a mal-aligned component.

Breaks of the bone are a rare complication that may necessitate revision knee replacement. To perform the procedure, a surgeon must remove damaged fragments and reconstruct the joint line. In case of osteoporosis-related fractures, the damaged bone may be completely exchanged with a larger component.

Implant Loosening

Implant loosening and wear can occur over time. These happen when the implant loosens from the underlying bone and can cause pain in the knee. The exact cause of loosening is still poorly understood.

However, experts believe that certain factors, including excess weight, high-impact activities, and wear of the plastic part or tibial spacer can cause the implant to loosen.

Additionally, young patients who underwent the initial knee replacement are at an elevated risk of revision knee surgery. This is because they may outlive the life span of their artificial knee.

What is recovery like following revision total knee replacement surgery?

After a revision knee surgery, a patient will also have the same recovery and rehabilitation process that they underwent when they received a primary knee replacement. It is worth noting, however, that recovery after the repeat operation is usually slower.

The type of postoperative care a patient may receive after a revision knee surgery includes medication, physical therapy, and the use of prescription blood thinners for blood clot prevention.

Medications are prescribed for pain management following surgery. Your doctor and nurses may use a combination of pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs), prescription opioids, and local anesthetics to minimize your pain.

Physical therapy, on the other hand, involves a physical therapist providing specific exercises that help strengthen the leg and restore an individual’s range of motion. This can be done in a span of three months or longer and aims to enable patients to return to their normal daily functioning as soon as possible.

Lastly, a doctor may also utilize certain measures to prevent blood clots and reduce leg swelling after knee revision surgery. These may include the use of compression boots, compression stockings, and prescription blood thinners.

The length of recovery following a knee revision procedure varies from person to person and may differ from their initial total knee replacement experience. While some patients take longer to fully recover, others heal more rapidly and experience significantly less discomfort compared to their first surgery.

Are you a candidate for knee revision surgery?

If you think you are experiencing the abovementioned symptoms that may qualify you for a knee revision surgery, you should speak to your doctor first and foremost. Your doctor will be able to determine whether you are a good candidate for the procedure according to the symptoms you are having.

If you or your loved one received an Exactech knee, ankle, and hip replacement for your surgery and are having signs that may be indicative of implant failure, you may be eligible to file a case against the product’s manufacturer.

Do not hesitate to contact us today to explore your legal options with our experienced and reliable personal injury lawyers.

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