Knee Replacement Revision

While a revision surgery involves many of the same risks as total knee replacement, it is significantly more complicated. It requires an exceptional specialist who has a long history of successful knee surgeries. When done correctly, a knee replacement revision can restore a patient to his or her previous level of activity. Dr. Nitin Goyal has the expertise and experience necessary to bring patients through knee replacement revision, restoring the mobility and freedom they deserve.

Reasons for implant failure

In many cases, knee replacement revision is required simply because the implant has reached the end of its life span. However, the revision may be necessitated from a number of conditions not involving the state of the implant. Reasons for implant failure include:

• Loosening. While the primary knee replacement surgery fixes the prosthetic very firmly where it belongs, it may become prone to loosening after many years of use. This is noticeable to the patient as instability, deformity or pain.
• Infection. This is generally caused by bacteria that settle in and around the prosthetic device. It may be due to unsanitary instruments in the original surgery or other contaminations present in the operating room. However, because sanitation standards are very strict, infection in the implant occurs less than 2% of the time.
• Mechanical failure. In some cases, the implant itself is defective. If this occurs, it is usually a short time after surgery and can be handled before any serious damage occurs. Dr. Goyal is careful only to use implants that offer proven, lasting results. His revision surgery will provide just that.
• Patient-related factors. Because each patient lives life with a different level of activity and physical strain, the same implant may last longer in some patients than others. In younger, more active patients, implants tend to reach the end of their life more quickly due to wear and tear. Other patient-related factors include obesity and previous incidence of inflammatory arthritis and other orthopaedic diseases.

Knee replacement revision procedure

In many cases, the knee replacement revision procedure in Dr. Goyal's North Virginia office involves two stages. The first stage serves the purpose of removing the old implant. Once this is done, Dr. Goyal will insert a polyethylene spacer as a temporary treatment for the failed implant.

During the second procedure, Dr. Goyal will remove the temporary spacer and reshape the surfaces of the knee. At this point, he will then install the new implants into the knee as a permanent fixture.

Important note: Because the original implants were intended to be permanent, there can be significant bone loss during their removal. For this reason, a bone graft is frequently required in knee replacement revision surgery. This graft can be taken from elsewhere on the patient’s body or it can be obtained from a donor, usually through a bone bank. This is a matter that should be thoroughly discussed with Dr. Goyal prior to surgery.

Recovery after knee replacement revision surgery

Following your knee revision surgery, the recovery process is similar to recovering from primary knee replacement surgery. Critical components during recovery include:

• Medication
• Physical therapy
• Exercise
• Incision care
• Follow-up

While walking may initially be assisted with a walking device, such as a cane or crutches, it is important to remain faithful to any exercise or physical therapy regimen prescribed by Dr. Goyal. During the recovery period, remaining mobile is crucial to a full recovery. The knee requires compression, pressure and resistance to adapt to the new implant. As the bones grow and properly adjust to the implant, walking and other movement will improve significantly.

When it comes to knee replacement revision surgery, it is crucial to choose a surgeon who has total familiarity with the complexities and peculiarities of the knee joint. Washington DC orthopedic surgeon Dr. Goyal has trained as a specialist in complex knee revision surgery, giving him the qualifications to bring patients through this unique surgical procedure. Call us today to find out why Dr. Goyal’s patients call it the best knee replacement revision Washington, DC and North Virginia have available.