A Failed Or Worn-Out Knee Replacement
When Your Knee Needs a Second Chance
Knee replacement surgery, also known as knee arthroplasty, is a procedure that replaces the damaged or worn-out surfaces of the knee joint with artificial implants, usually made of metal and plastic. It can relieve pain, improve function, and enhance the quality of life for many people who suffer from knee arthritis or other conditions that affect the knee joint.
Like any surgical procedure however, knee replacement surgery has some risks and potential complications, both during and after the procedure. In some cases, the knee replacement may fail or cause problems that require a revision procedure, which is a second operation to remove or replace some or all of the original implants.
Knee replacement complications are unexpected issues that may arise during or after surgery. They can often be resolved with appropriate treatment and do not necessarily result in the failure of the joint replacement. Knee replacement failure on the other hand typically involves issues that result in the need for revision surgery. This means that the artificial joint no longer functions correctly, leading to persistent pain, instability, or functional limitations.
SYMPTOMS A PREVIOUS KNEE REPLACEMENT HAS COMPLICATIONS OR HAS FAILED
The symptoms of complications or failures of a previous knee replacement surgery may vary depending on the type, timing, and severity of the problem. Some of the common symptoms however may include:
Pain:in the knee, especially with movement, weight-bearing, or after prolonged inactivity
Swelling: in the knee, due to fluid accumulation or inflammation
Reduced range of motion or mobility: in the knee, making it difficult to bend or straighten the knee
Grinding, clicking, or cracking sounds: in the knee, due to the implants rubbing against each other or against the bone
Deformity: in the knee, such as bowing, knock-knees, or buckling
Difficulty walking, climbing stairs, or performing daily activities
Fever, chills, or drainage, indicating an infection
COMMON COMPLICATIONS WITH KNEE REPLACEMENT SURGERY
There are many possible causes of complications of a previous knee replacement surgery, depending on the type, timing, and severity of the problem. Some of the most common causes include:
Infection is a risk with any surgical procedure. It can occur during or after the surgeryaffecting the skin, the soft tissues, the bone, or the implants. Infection can cause pain, swelling, redness, fever, drainage, or loosening of the implants and can be caused by bacteria, viruses, fungi, or other microorganisms that enter the surgical site, the bloodstream, or the implants.
Infection can be prevented by following proper hygiene, wound care, and antibiotic protocols before, during, and after the procedure. If Infection occurs, it can be treated by antibiotics, drainage, debridement, or, with severe cases – revision surgery.
Blood clots can form post-surgery. If they travel to the lungs or heart, it can be life-threatening. Medications and preventive measures are used to manage this risk.
Loosening is a complication that can occur over time, as the implants wear out or detach from the bone. Implant loosening can cause pain, instability, reduced mobility, or implant failure and can be caused by several factors such as; implant design, implant material, implant size, implant alignment, bone quality, bone loss, infection, inflammation, or high-impact activities.
Loosening can be prevented by choosing the appropriate implant, ensuring proper implant placement, maintaining bone health, avoiding excessive weight or stress on the joint, and following the recommended activity level after the procedure. Implant loosening can be treated by revision surgery, which may involve replacing the implants, adding bone grafts or metal augments, or changing the implant fixation method.
Some patients experience stiffness after surgery. Physiotherapy and rehabilitation can often help with this complication.
Knee instability can result from incorrect implant placement or ligament issues. Treatment may involve bracing or revision surgery.
FAILURE OF A KNEE REPLACEMENT PROCEDURE
Knee replacement failure is a more serious issue compared with knee replacement surgery complications and may manifest as:
As mentioned, loosening of the implant can cause severe pain, and revision surgery may be required.
Infection can sometimes lead to implant failure if not addressed promptly.
Fractures around the implant can compromise the artificial joint’s stability. A fracture can occur during or after surgery, as the bone around the knee joint breaks or cracks, causing pain, swelling, reduced mobility, or implant failure. Fracture can be caused by several factors, such as bone quality, bone loss, implant design, implant size, implant alignment, implant fixation, implant movement, or trauma.
Fractures can be prevented by maintaining bone health, choosing the appropriate implant, ensuring proper implant placement, avoiding excessive weight or stress on the joint, and following the recommended activity level aftersurgery. A fracture can be treated by immobilisation, fixation, or revision surgery, which may involve repairing the bone, replacing the implants, adding bone grafts or metal augments, or changing the implant fixation method.
Wear is a complication that can occur over time, as the surfaces of the implants rub against each other or, against the bone, causing friction, debris, or damage. Implant wear can cause pain, inflammation, infection, loosening, or implant failure and can be caused by several factors, such as implant design, implant material, implant size, implant alignment, implant fixation, implant movement, or high-impact activities.
Implant wear or breakage can be prevented by choosing the appropriate implant, ensuring proper implant placement, avoiding excessive weight or stress on the joint, and following the recommended activity level after the surgery. Wear can be treated by revision surgery, which may involve replacing the implants, adding bone grafts or metal augments, or changing the implant fixation method.
Damage to the surrounding ligaments can lead to instability.Instability can occur during or after the surgery, as the knee joint becomes unstable or dislocated, causing pain, swelling, reduced mobility, or implant failure. Instability can be caused by several factors, such as ligament damage, ligament laxity, implant design, implant size, implant alignment, implant movement, or trauma.
While complications and failure are possible, they can often be managed with proper care and treatment. The key is early detection and intervention. If you experience pain, instability, or any signs of implant issues, consult with your orthopaedic surgeon for a thorough evaluation and personalized treatment plan. Remember, with the right care and attention, many complications or failures of knee replacement surgery can be successfully resolved.