Second Opinion on Previous Knee Replacement (Revision Surgery)
Revision Knee Surgery in Oklahoma City
Dr. Paul Jacob is a fellowship-trained hip and knee replacement specialist providing revision knee surgery in Oklahoma City, Oklahoma. With advanced training in adult reconstruction at the Cleveland Clinic, Dr. Jacob specializes in evaluating and treating problems that can develop after a previous knee replacement, including implant wear, loosening, instability, infection, stiffness, and bone loss.
Although knee replacement can provide long-term pain relief and improved function, some implants may eventually require revision. Because revision knee surgery can be more complex than primary knee replacement, specialized evaluation and individualized surgical planning are important when determining the appropriate treatment.
Revision knee replacement surgery
Revision knee replacement surgery involves replacing part or all of your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.
The knee joints are lined by soft articular cartilage that cushion the joints and aid in smooth movement of the joint bones. Degeneration of the cartilage due to wear and tear leads to arthritis, which is characterized by severe pain.
During total knee replacement, the damaged cartilage and bone is removed from the knee joint and replaced with artificial components. Artificial knee joints are usually made of metal, ceramic or plastic and consist of the femoral component and the tibial component.
Indications
Revision knee replacement surgery may be advised to patients if they have one or more of the following conditions:
- Trauma to the knee joint
- Chronic progressive joint disease
- Increased pain in the affected knee
- Worn out prosthesis
- Knee instability or a feeling of giving way while walking
- Loosening of the prosthesis
- Infection in the prosthetic joint
- Weakening of bone around the knee replacement, a process known as osteolysis (bone loss)
- Stiffness in the knee
- Leg length discrepancy
- Fracture
Surgical procedure
Revision knee replacement surgery may involve the replacement of one or all of the components.
The surgery is performed under general anesthesia. Your surgeon makes an incision over the knee to expose the knee joint. The kneecap along with its ligament may be moved aside so that there is enough room to perform the operation. Then the old femoral component of the knee prosthesis is removed. The femur is prepared to receive the new component. In some cases the damaged bone is removed and bone graft or a metal wedge may be used to make up for the lost bone.
Next the tibial component along with the old plastic liner is removed. The damaged bone is cut and the tibia is prepared to receive the new component. Similar to the femur, the lost bone is replaced either by a metal wedge or bone graft. Then, a new tibial component is secured to the end of the bone using bone cement. A new plastic liner will be placed on the top of the tibial component. If the patella (kneecap) has been damaged, your surgeon will resurface and attach a plastic component. The tibial and femoral components of the prosthesis are then brought together to form the new knee joint, and the knee muscles and tendons are reattached. Surgical drains are placed for the excess blood to drain out and the incision is closed.
Postoperative care
Following revision knee replacement surgery, a Continuous passive motion (CPM) machine may be used to allow the knee joint to slowly move. The machine is attached to the treated leg which slowly moves the joint through a controlled range of motion, while you relax.
You can walk with crutches or a walker. You will be sent for rehabilitation within a couple days of surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore range of motion to the knee. Your physical therapist will also provide you with a home exercise program to strengthen thigh and calf muscles.
Knee immobilizers are used when performing physical therapy, walking and while sleeping in order to keep the knee stabilized.
Risks and complications
As with any major surgical procedure, there may be certain risks and complications involved with revision knee replacement surgery. The possible complications after revision knee replacement include:
- Stiffness in the knee
- Infection
- Bleeding
- Formation of blood clots in the leg veins
- Injury to nerves or blood vessels
- Prosthesis failure
- Patella (kneecap) dislocation
- Ligament injuries
Why Choose Dr. Paul Jacob for Revision Knee Surgery in Oklahoma City?
Dr. Paul Jacob is a Cleveland Clinic-trained adult reconstruction specialist whose practice focuses on hip and knee reconstruction. His expertise includes primary and revision knee replacement, complex joint reconstruction, robotic-assisted surgery, minimally invasive techniques, and outpatient joint replacement for appropriately selected patients.
Revision knee surgery may involve replacing one or more components of a previous knee implant and addressing issues such as bone loss, instability, infection, or damaged surrounding tissues. Dr. Jacob evaluates the existing implant, knee alignment, bone quality, soft tissues, and underlying cause of failure to develop an individualized treatment strategy.
Patients considering revision knee surgery in Oklahoma City may benefit from:
- Fellowship training in adult reconstruction at the Cleveland Clinic
- Dedicated focus on hip and knee reconstruction
- Experience with revision knee replacement
- Evaluation of painful, loose, or failed knee implants
- Individualized planning for complex knee reconstruction
- Comprehensive postoperative rehabilitation guidance
Revision Knee Surgery FAQs
Why might I need revision knee surgery?
Revision surgery may be recommended when a previous knee replacement develops problems such as implant wear, loosening, infection, instability, stiffness, fracture, bone loss, or persistent pain that affects mobility and quality of life.
How do I know if my knee replacement has failed?
Increasing pain, swelling, stiffness, instability, difficulty walking, or a feeling that the knee is giving way may indicate a problem with a previous knee replacement. Your surgeon may use a physical examination, X-rays, and other diagnostic tests to determine the cause.
Is revision knee replacement more complicated than primary knee replacement?
Revision surgery can be more complex because the surgeon may need to remove existing components, address bone loss, manage scar tissue, and restore knee stability and alignment. The complexity depends on the reason for revision and the condition of the existing knee replacement.
What happens during revision knee surgery?
The procedure depends on the underlying problem. The surgeon may replace one or more components of the existing knee replacement, remove damaged tissue or implants, address bone loss with appropriate reconstruction techniques, and place new components designed to restore stability and function.
How long does recovery take after revision knee surgery?
Recovery varies depending on the complexity of the procedure, bone quality, overall health, and rehabilitation needs. Revision knee replacement may require a longer recovery than primary knee replacement, with physical therapy playing an important role in restoring strength and mobility.
What are the risks of revision knee replacement?
Potential complications include infection, bleeding, blood clots, stiffness, nerve or blood vessel injury, implant failure, kneecap complications, ligament problems, and persistent pain. Dr. Jacob can discuss the potential risks and benefits based on your individual condition.
Revision Knee Surgery in Oklahoma City
If you are experiencing persistent pain, instability, stiffness, or other problems following a previous knee replacement, Dr. Paul Jacob provides specialized revision knee surgery in Oklahoma City. His Cleveland Clinic training and dedicated focus on adult reconstruction allow him to evaluate complex knee replacement problems and develop an individualized treatment plan.
Schedule an evaluation with Dr. Paul Jacob in Oklahoma City to determine whether revision knee surgery may be appropriate for your condition. Patients from Edmond, Norman, and surrounding Oklahoma communities can receive specialized evaluation and treatment for painful, failed, or complicated knee replacements.
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