Revision Knee Replacement Surgery

Dr Daniel Meyerkort – Perth Orthopaedic & Sports Medicine Centre

Knee replacement occasionally needs to be re-done. The most common reasons for failure reported by the Australian Joint Registry are:

  • Loosening
  • Infection
  • Patello-femoral (knee cap) pain
  • Pain
  • Instability

Do I need follow up after my knee replacement?

Any prosthesis that was previously well performing and now is painful or impairing function requires a follow up. As a first step, an XR should be performed and you should receive a referral back to your original treating surgeon. If they are not available, follow up can be arranged through a hip/knee orthopaedic surgeon.

If your joint is functioning well and you are aged under 70 years of age, the Arthroplasty Society of Australia recommend follow up at 1-2 years post op, then 7- 10 years later, followed by a check up every 3-5 years after this.

Patients aged over 70 with a well functioning joint and a prosthesis, with a known excellent track record, do not require follow up.

What Does Revision Knee Replacement Surgery Involve?

Surgery is tailor-made according to the mode of failure and the demands of the patient. It ranges from what is considered a minor revision (exchange of the polyethylene liner or knee-cap resurfacing) to removal of all components with a complete revision. Knee revision surgery is larger and more complex than your original knee replacement. Significant improvements in pain and function are usually achieved, however, results are usually not as excellent as they were in the original operation.

Risks of Revision Knee Replacement Surgery

Risks with revision knee replacement are higher than the original procedure. These risks include:

  • Wound breakdown
  • Stiffness/reduced range of motion/instability
  • Infection
  • Bleeding
  • Blood clots
  • Ongoing pain
  • Fracture
  • Damage to nerves or blood vessels
  • Medical problems such as heart attack, stroke, lung problems

Learn about Robotic Total Knee Replacement


What is a revision knee replacement?

Revision knee replacement is redo surgery of your original knee replacement. It can range from being relatively minor (plastic liner change only) to a major & complex replacement of all components. The most common reasons for revision knee surgery are infection, loosening, lysis, instability, plastic wear, dislocation and pain.

What are the signs of knee replacement failure?

If you have a knee replacement that was functioning well and now is becoming painful this is a warning sign that it may be failing. You should have an x-ray and seek review from an Orthopaedic Surgeon. Other signs of failure include swelling, instability and loss of function.

How do you break up scar tissue after knee replacement?

The best way to prevent scar formation is early movement with your physiotherapist. Rarely a manipulation under anaesthetic or surgical scar removal is required.

Can you break a knee replacement by falling?

It is very uncommon to break the knee replacement implant however fracture of the bone around the prosthesis occurs more commonly. Typically, we see this in elderly patients with poor quality bones (osteoporosis) who are also frail and frequently falling. The treatment is usually surgical fixation of the fracture  with a plate and screws.

Can a knee replacement last 30 years?

Yes, modern knee replacement is expected to last 20 – 30 years for most people. It is dependent on your age and level of function. Data from the Australian Joint Registry  suggest that 80% of knee replacements will last 20 years.

What are the most commonly reported problems after revision knee replacement?

Revision  knee replacement is major surgery and has risk associated with the procedure. The most common risks and problems are infection, stiffness, instability, pain, blood clots, loosening and fracture. Despite these risks, most patients have a good result from surgery.


West Perth & Canning vale