The knee joint is made up of three main bones.

• The lower end of the thighbone (femur)
• The upper end of the shinbone (tibia)
• The kneecap (patella), which slips into a groove that's on the end of the thighbone

The surface of the ends of the bones is covered with cartilage that provides cushioning to the ends of each bone.

A total knee replacement is the replacement of the major parts of the knee joint with man-made pieces of metal and plastic. The three parts replaced are:

• The lower end of the femur, the large bone in the top of the leg
• The upper end of the tibia, the larger bone in the bottom part of the leg
• The backside of the patella, also known as the kneecap

An artificial knee improves knee joints that have been damaged by injury or arthritis. The replacement typically lasts about ten to fifteen years, depending on:

• On the level of activity
• Daily use of the joint
• Other factors

Some people need to have a revision or replacement of their artificial knee. This involves replacing the damaged artificial knee joint with a new one. Revisions are more common in patients who are:

• Younger and more active (due to increased wear and tear)
• Obese (increased wear and loosening)
• Recovering from a knee replacement that was done due to inflammatory arthritis, avascular necrosis (death of bone), or a previous knee fracture (increased risk of loosening)

Revision of a total knee replacement involves:

• Removing the previously inserted artificial joint
• Cleaning out the surrounding area
• Inserting a new artificial joint

Your healthcare provider may recommend a revision of your total knee replacement if you have:

• Wear and tear of the artificial joint has resulted in it not fitting as well, causing abnormal movement and pain
• Severe pain in an artificial knee joint that has not responded to treatment and stops you from doing your normal daily activities (i.e., walking, normal household tasks and other usual daily activities)
• Signs of infection in an artificial knee joint (i.e., redness, warmth, drainage from incision and fever)
• An unstable artificial knee joint that causes limited, uncomfortable or painful movement of the knee joint

Knee revision surgery can fix the problems listed above, decrease pain and allow normal knee movement and stability.

Prior to the surgery, tell your healthcare provider about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before the surgery. These may include:

• Medications you should not take before the surgery, such as blood thinners or aspirin
• Regular medications you should continue to take on the day of your surgery
• How many hours you should stop eating and drinking before surgery
• How to prepare your home for your return after you are discharged
• Instructions on getting around with a cane, walker or crutches

If you are a smoker, you should quit smoking, as it can interfere with your healing and recovery.

During surgery, you will receive anesthesia to keep you comfortable and pain free.

• General anesthesia is the most common type of anesthesia for a revision of a total knee replacement.
• With general anesthesia, the anesthesiologist puts you into a deep sleep. You will not be able to see, hear or feel anything.

After surgery, you will probably need to stay in the hospital for several days to recover.

• Although most people are able to go home after discharge, some need to go to a rehabilitation hospital for a few days.
• Full recovery can take many months and typically involves exercise and physical therapy.
• Pain medication and help at home will be needed while you complete your recovery.

What should I ask my healthcare provider before having a revision of my total knee replacement?

• What is my diagnosis and reason for the surgery? Are there nonsurgical alternatives available to me? How will the surgery affect my daily life?
• How long should my earlier artificial knee replacement have been expected to last?
• How many artificial knee replacements have you performed? What is your success and complication rate?
• What tests do I need? What is the reason for those tests? Will the test results change my treatment plan?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• What kind of sedation will I have? What are the possible side effects?
• What type of recovery should I expect and how long will it take?
• When might I start to see improvement in my symptoms?
• What are my follow-up plans and what symptoms should I report before my next appointment?
• How many knee revisions have you done? What have your results been?

Make sure you understand your treatment plan, any possible alternatives and what medications are recommended (including possible side effects). Do not forget to make arrangements for transportation to and from the facility and for help at home. Your surgeon should also let your primary care physician know the details of your surgery and treatment plan.

Source UHC.com

Also known as:

Total Knee Replacement

TKR

Revision

Replacing Knee

Repair Knee

Osteoarthritis

Knee Replacement - Revision

Knee Replacement