Total knee replacement surgery is one of many very successful operations in orthopaedic surgery, but over the time it can fail. There can be multiple reasons. It can be infection, loosening and wear of implants, instability, stiffness of the knee and fracture around the prosthesis.
Multiple tests are performed to find the cause of pain in the replaced knee including x rays, MRI, CT scan and bone scan depending on clinical exam.
Most important is to rule out is infection. It can be done ordering blood tests and if needed aspiration of the knee and sending that fluid for examination. If infection is diagnosed then revision knee surgery is done in two stages. In first stage previous implant is removed, infection is cleaned and spacer implant is inserted which is loaded with antibiotics. Once infection is eradicated, the revision knee replacement is performed.
If the pain is because of loosening and wear of implants or instability then one stage revision knee replacement is performed.
In revision knee replacement surgery usually the stems, cones, sleeves and constrained implants are used depending on soft tissue and ligaments.
Recovery and rehab after the revision knee surgery is usually longer than primary.