If you have had a total knee replacement you will understand that they don’t last forever. Just like any bearing there will be some wear and tear between the surfaces. Technology has moved on and the types of material we use today for knee replacements both partial resurfacing and total knee replacements have improved. In total knee replacements and partial resurfacings the most commonly used surfaces are highly engineered and polished cobalt chrome moving on high molecular weight polyethylene. There are some variation to those surfaces and in-particular if you have a nickel allergy or sensitivity we can use titanium instead of cobalt chrome with a special surface coating to aid the frictionless movement of the joint, or more recently we have used one of the worlds first all ceramic knee replacements from LIMA orthopaedics. This implant has no metal at all in its construction. The femur (thigh) component is made of zirconia one of the hardest materials in existence moving on highly cross-linked polyethylene.
We anticipate from our joint registries that a total or partial knee resurfacing should last up to 20 years. If however you do require further surgery to change a well functioning knee replacement that has started to fail or have had some other problems with your knee replacement or resurfacing, then revision surgery may be required. This is highly complex and specialised surgery. The surgery requires very careful investigation and understanding as to what the problem is and why the implant has failed and how a revision or redo surgery can address those issues and provide you with an improvement in your symptoms. This will often require an MRI or CT scan, removing some fluid from the knee and testing for possible infection as a cause of the failure, nuclear medicine bone scan tests to identify if the previous implant is loose or well fixed.
Once a reason has been identified then moving on to surgery to address those problems can take place.
This surgery varies greatly from person to person and is very much a custom operation. The old implant must be removed , and in order to give you a functioning new joint, a much more complex implant is used to provide stability and longevity for the future.
The surgery will often take up to 2-3 hours to complete and the recovery and time in hospital is often a little longer than a first time knee replacement.
What has been identified in studies as one of the most important factors in a successful revision surgery is that it is done by someone who carries out this surgery regularly and has the resources available to them in a specialised centre to safely carryout this surgery. This is a regular surgery carried out by Mr Frame in University Hospital Southampton in Hampshire, which is a tertiary referral centre for complex revision surgery.
Call us to find out more about revision surgery or if you have a painful or problematic partial or total knee replacement.