KNEE REVISION SURGERY
Knee Joint Revision Surgery: Restoring Mobility and Alleviating Pain Through Expert Care
Why Knee Revisions Become Necessary
While most knee replacements provide excellent outcomes for 15-20 years, complications can arise that necessitate revision surgery. Implants can fail for numerous reasons including infection, loosening, fracture, stiffness, instability and wear.
Infection poses one of the most serious risks for implant failure. Though rare, with a less than 1% risk with current techniques, knee infections can be devastating. Bacteria can latch onto the large metal and plastic components in a process called biofilm formation, making the bacteria inaccessible to antibiotics. Even well-fixed implants may need replacement to eradicate infection and stop associated swelling and pain.
Aseptic loosening is another common cause of failure, as the implant loses its grip on the bone over time. This loosening can result from high impact activities, excessive weight, and wear generating tiny particles that hinder the bond between the implant and bone. Osteolysis, or bone tissue loss, also contributes to loosening and potential fracture risk.
More active, younger patients face higher revision rates since their implants experience more cumulative stress over time. Those who are obese also have elevated risks of loosening and infection due to increased forces on the joint and wound healing challenges. Prior surgeries also raise infection chances and predispose implants to faster failure.
When nonsurgical treatments like medications, activity changes, braces, or injections cannot alleviate swelling, pain and lost function, Dr. Seigel may recommend revision surgery. He helps patients understand when replacements require replacement.
Components of Knee Revision Surgery
Since knee revision surgery is more complex than initial replacement, it requires extensive planning and a surgeon highly experienced in revision techniques. Dr. Seigel's expertise facilitates optimal outcomes even in complicated reconstructions with significant bone loss, instability, infection or fractures.
The surgery begins with removal of the old implant components and any deteriorated bone. Bone grafts from the patient’s own body or bone banks fill voids to reinforce the knee. After reshaping the joint, Dr. Seigel uses specialized revision implants and precision techniques to establish optimal fit and function in the newly reconstructed knee.
To enhance stability, he may use wedges, wires, screws or custom augments. For infection cases, components may be replaced in one or two stages along with extensive antibiotic treatment. Temporary drainage tubes prevent fluid buildup and specialized wound dressings are often employed to minimize postoperative complications.
Meticulous surgical techniques maximize outcomes while reducing risks like bleeding, nerve damage and fractures. Dr. Seigel’s skill and care enable him to handle even the most complex revision cases involving massive bone loss, instability or prior complications.
Recovering After Surgery
The recovery process mirrors that of primary knee replacement but sometimes takes longer depending on the extent of reconstruction required. Hospital stays average 1-3 days. Early rehabilitation starts motion exercises on day 1 and patients are often able to walk within 24 hours after surgery.
Post-op care focuses on pain management, blood clot prevention, monitoring for complications, and appropriate wound care. Antibiotics prevent infection and braces may provide extra protection temporarily. Assistive devices like walkers or crutches help stabilize weightbearing initially after surgery.
Outpatient physical therapy continues for 2-3 months to restore strength and mobility. Some temporary activity restrictions may be needed to allow proper healing before resuming normal function. Most patients see significant improvements in stability, range of motion and pain levels as the knee recovers.
Risks and Complications
Since revision surgery is more involved than initial replacement, risks of complications increase. Potential issues that may arise include:
- Infection: Revisions have higher infection rates than first-time replacements. Strict sterile protocols during surgery lower this risk.
- Bleeding: Meticulous surgical techniques help minimize bleeding risks. Blood transfusions may be needed with extensive reconstructions.
- Blood clots: Anticoagulants thin the blood to reduce risks of dangerous clots. Early mobilization also helps decrease clotting risks.
- Fractures: Compromised bone from prior osteoarthritis or revisions predispose the knee to fracture risks. Careful operating and controlled mobilization protect healing bone.
- Nerve damage: Careful dissection and implant positioning aim to avoid impacting nerves that control sensation and function in the leg.
- Persistent pain: Some residual discomfort may linger after revision surgery depending on the complexity of the case. Most patients obtain significant pain reduction but outcomes are case dependent.
- Wound issues: Some drainage and swelling is common initially after surgery. Proper dressings and wound care reduce risks of prolonged drainage in obese patients or those with prior infections.
With Dr. Seigel’s expertise in managing complex revisions, risks are minimized through meticulous surgical techniques and patient-centered care. He takes a holistic approach to recovery aimed at providing the best possible outcome for each patient.
Expected Outcomes After Surgery
While full restoration of function is not guaranteed, most patients undergoing knee revision surgery experience substantial improvements in stability, range of motion, and pain levels. Each case is unique based on the degree of joint deterioration and the patient’s underlying health. But advanced techniques now allow excellent revision outcomes even in complex cases.
Some residual discomfort or stiffness is possible, especially for extensive reconstructions. But most patients obtain enhanced joint function and mobility. Around 80% of patients report good or excellent results from well-executed revisions. Strict activity modifications may be required after surgery to protect delicate joint tissues and optimize longevity of the new components.
With his dedication to innovative care and passion for optimal outcomes, Dr. Seigel strives to help each patient achieve their highest sustainable level of function after revision surgery. He customizes care plans to meet individual patient needs and concerns during the recovery process.
Alternatives to Revision Surgery
For severe infections or joint destruction, more radical procedures like arthrodesis (joint fusion) or even amputation may be required instead of revision replacement. But these approaches are rare last resorts when all other options have failed. They aim to resolve intractable pain but result in permanent loss of knee mobility.
Joint fusions use rods and plates to rigidly join femur to tibia bones together, eliminating all motion. Amputation completely removes the lower leg and requires prosthetic fitting. Because both alternatives severely reduce function, they are reserved only for the most extreme joint failures not amenable to revision.
For most failed replacements, a well-executed revision surgery provides vastly improved outcomes compared to these permanent mobility-limiting options. Dr. Seigel’s expertise in advanced revision techniques makes rehabilitation possible even in many complex cases previously considered non-reconstructable.
Choosing an Experienced Revision Surgeon
Since knee revision surgery is highly specialized, choosing a surgeon with expertise in revisions is crucial to achieving optimal outcomes. As a seasoned orthopedic specialist with over two decades of experience, Dr. Herrick Seigel provides trusted surgical care and patient-centered guidance through every step of the revision process.
His passion for innovation, commitment to meticulous technique, and holistic approach to recovery delivers the best possible outcome for each patient. Dr. Seigel individualizes care plans to help patients understand their options and make informed decisions about pursuing knee joint revision surgery.
With advanced technologies and proven surgical skills, Dr. Seigel gives patients renewed hope for pain relief and restored function. Even patients requiring complex revisions with massive bone loss, prior complications or infections can benefit from his specialized revision expertise. When initial knee replacements require replacement, Dr. Seigel’s trusted care delivers personalized solutions for reduced pain and renewed mobility.
To learn more about the range of orthopaedic options available to you, contact Dr. Herrick J. Siegel at 205-930-8339.