Revision Total Knee Replacement Surgery in Jaipur
Total knee replacement is one of the most successful procedures of all medicine. In the vast majority of cases, this enables people to lead richer, more active lives free of chronic knee pain. Over time, however, knee replacements can fail for a variety of reasons. When this happens, you may have pain and swelling in your knee.
It may also feel stiff or unsteady, making it difficult to perform your daily activities.
Revision Total Knee Replacement Surgery in Jaipur is one of the best surgeries to consider because it will help people to get rid of the pain easily. Whether they are going through problems like osteoarthritis, rheumatoid arthritis, and others or whether they got injured during an accident. A person will be going to get a stable knee after it.
If your knee replacement fails, your doctor may recommend a second surgery – revision total knee replacement. In this procedure, your doctor removes some or all of the original prosthesis and replaces them with new ones.
Although both procedures have the same goal—to relieve pain and improve function—revision surgery differs from primary total knee replacement. This is a longer, more complicated procedure that requires extensive planning and specialized implants and equipment to achieve a good result.
Description - What is Revision Total Knee Replacement
1. Implant Loosening and Wear
For a total knee replacement to work properly, an implant must remain firmly attached to the bone. During the initial surgery, the implant was either cemented to the bone or press-fitted to allow the bone to grow on the surface of the implant. In any case, the implant was firmly fixed. Over time, however, an implant can loosen from the underlying bone, causing knee pain.
The cause of the loosening is not always clear, but high-impact activities, excessive body weight, and wear of the plastic spacer between the two metal components of the implant are all factors that may contribute.
In addition, patients who are younger when they undergo initial knee replacement may “exclude” the life expectancy of their prosthetic knee. For these patients, there is a high long-term risk that loosening or wear will result in the need for revision surgery.
In some cases, tiny particles that can damage the plastic spacer accumulate around the joint and are attacked by the body’s immune system. This immune response also attacks the healthy bone surrounding the implant, causing a condition called osteolysis.
In osteolysis, the bone around the implant wears away, causing the implant to become loose or unstable. Advances in the material science and quality of plastics have made osteolysis less common today than in previous decades.
2. Infection
Infection is a potential complication of any surgical procedure, including total knee replacement. Infection can happen while you are in the hospital or after you go home. It can happen even after years.
If an artificial joint becomes infected, it can become stiff and painful. The implant may begin to lose its attachment to the bone. Even if the implant remains properly fixed to the bone, pain, swelling and drainage from the infection usually become necessary.
Modification for infection can be done in one of two ways, depending on the type of bacteria, how long the infection has been present, the degree of infection, and the patient’s preferences.
Modification for infection can be done in one of two ways, depending on the type of bacteria, how long the infection has been present, the degree of infection, and the patient’s preferences.
Debridement and implant retention: In some cases, the bacteria can be washed away, the plastic spacer can be exchanged, and the metal implant can be left in place.
Staged surgery: In other cases, the implant must be removed entirely. There are two types of staged surgery:
In 2-stage surgery, the implant is removed, the joint is sutured, and a temporary cement spacer is placed in your knee. This spacer is treated with antibiotics to fight infection and will remain in your knee for several weeks. During this time, you will also receive intravenous antibiotics.
When the infection has cleared up, your doctor will perform a second surgery to remove the antibiotic spacer and insert a new prosthesis.
In 1-stage surgery – which is usually reduced – the implant is removed, the joint is washed, and a new implant is placed during the same surgery. This is followed by intravenous antibiotics.
Your doctor will talk to you about which option is best for you. Removal of the implant is more likely to cure the infection, but is associated with a longer recovery time.
3. Instability
If the ligaments surrounding your knee become damaged or improperly balanced, your knee may become unstable. Since most implants are designed to work with the patient’s existing ligaments, any change to those ligaments can prevent the implant from working properly.
You may experience frequent swelling and a feeling that your knee is “giving way.” If knee instability cannot be treated through non-surgical means such as bracing and physical therapy, revision surgery may be required.
4. Stiffness
Sometimes a total knee replacement may not help you gain the range of motion you need to perform daily activities. This can happen when excessive scar tissue has formed around the knee joint. If this happens, your doctor may try “manipulation under anesthesia.”
In this procedure, you are given anesthesia so that you do not feel pain. The doctor then bends your knee in an attempt to break up the scar tissue. In most cases, this procedure is successful in improving the range of motion.
Sometimes, however, the knee remains stiff. If extensive scar tissue or the condition of components in your knee is limiting your range of motion, revision surgery may be needed.
5. Fractures
A periprosthetic fracture is a broken bone that occurs around the components of a total knee replacement. These fractures are often the result of a fall, and usually require revision surgery.
In determining the extent of modification needed, your doctor will consider several factors, including the quality of the remaining bone, the type and location of the fracture, and whether the implant is loose.
When a bone breaks down or becomes weakened by osteoporosis, the damaged part of the bone may need to be completely replaced with a larger revision component.
Preparing for Revision Total Knee Replacement
Medical Evaluation
You will be asked to schedule a complete physical exam with your primary care doctor several weeks before the revision surgery. This is essential to make sure you are healthy enough to have surgery and complete the recovery process.
Patients with chronic medical conditions such as heart disease may also be evaluated by a specialist, such as a cardiologist, prior to surgery.
Testing
imaging test. Your doctor will usually order imaging tests to learn more about the condition of your knee.
X-ray
These provide images of dense structures such as bone. Your doctor may order X-rays to be taken around the area of the joint replacement to look for loosening or changes in the position of the components.
Other imaging Tests
A nuclear medicine bone scan can help determine whether the prosthesis has come loose from the bone. In some cases, a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan will be used to help determine why your kneecap has failed and provide more information about the condition of the bone.
If you are available with insurance, then you can ask the provider and get an idea of how much it will be going to cover. Rest, you can conclude how much you are ready to afford.
laboratory Test
Your doctor may order blood tests to determine if you have an infection. He may also aspirate your knee. In this procedure, joint fluid is removed using a needle and syringe, then analyzed in a laboratory to determine if infection is present.
Surgical Procedure for Revision Total Knee Replacement
You will either be admitted to the hospital on the day of surgery or you will go home the same day. Plans to either be admitted or go home should be discussed with your doctor prior to your surgery.
Anesthesia
Before surgery, you will be evaluated by a member of the anesthesia team. The most common types of anesthesia are general anesthesia (put you to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake but your body is numb below the waist). With your input the anesthesia team will determine what type of anesthesia would be best for you.
Process - Revision Total Knee Replacement Surgery
Revision total knee replacement is more complicated and time consuming than primary total knee replacement. In complicated cases, surgery can take several hours.
To begin, your doctor will follow the line of the incision made during your primary total knee replacement. The incision may be longer than the original, however, to allow removal of older components. Once the incision is made, the doctor will move the kneecap and tendon to the side to reveal your knee joint.
Your doctor will examine the soft tissues of your knee to make sure they are free of infection. He or she will assess all metal and/or plastic parts of the prosthesis to determine which parts are worn out or loosened or out of position.
If necessary, your doctor will remove the original implant very carefully to preserve as much bone as possible. If cement was used in the primary total knee replacement, this is also removed. Removing this cement from the bone is a time-consuming process that adds to the complexity and length of revision surgery.
After removing the original implant, your doctor will prepare the bone surface for the revision implant. In some cases, there may be significant bone loss around the knee. If this happens, metal enhancements and platform blocks can be added to the main components to make up for the bone shortfall.
Rarely, bone graft material may be used to help rebuild the knee. The graft can come from your own bone (autograft) or from a donor (allograft).
Finally, your doctor will insert special revascularization implants, repair any surrounding soft tissue that is damaged, and carefully examine the range of motion of the joint. A drain may be placed in your knee to collect any fluid or blood left over after surgery.
After surgery, you will be taken to the recovery room, where you will stay for several hours while your recovery from anesthesia will be monitored. After you wake up, you will be taken to your hospital room.
Complications in Revision Total Knee Replacement Surgery
Like any surgical procedure, there are risks associated with revision total knee replacement. Because the procedure is longer and more complicated than a primary total knee replacement, it carries a higher risk of complications. Before your surgery, your doctor will discuss each risk with you and take specific measures to help avoid potential complications.
Potential risks and complications of revision surgery include:
- Poor wound healing
- Reduced range of motion or stiffness in the knee
- Infection in the wound or new prosthesis
- Bleeding
- Blood clots in the legs that can travel to the lungs (pulmonary embolism)
- Bone fracture during surgery
- Damage to nerves or blood vessels
- Medical problems such as heart attack, lung complications, or stroke
Long Term Results in Revision Total Knee Replacement
Most patients who have revision surgery experience favorable long-term outcomes, including pain relief and increased stability and function. Complete pain relief and restoration of function are not always achievable, and some patients may still experience pain or knee stiffness after revision surgery.
Who to Consult for Revision Total Knee Replacement Surgery in Jaipur?
If you have no option available for consultation, then “Dr. Arun Partani” is the right one for you to approach. He is one of the best knee replacement surgeons in Jaipur.
Whether you are looking forward to knowing how to resolve the issue of whether you have any queries considering revision total knee replacement surgery, he will be going to resolve every query you are having. He will help you to get rid of the problem you are facing.
Also, in his career till yet, he has done almost a 7000+ surgeries, and all of them are successful. Also, the best part about approaching Partani Clinic is, they are available with all the necessary equipment.
About Partani Clinic
Partani clinic is one of the best clinics to approach whenever you are facing any issues considering joints. Dr. Arun Partani is the sole proprietor of this clinic. They will not only help you in understanding the problem but will also suggest the measures you can take.
They both are experienced enough that you will not feel like they are not listening to your questions. In the case of surgery, they will also suggest the things which are required before and after surgery. The experience they have will be going to change your life, and the change you will be going to have is for good only. so looking for Revision Total Knee Replacement Surgery in Jaipur must book an appointment at Partani Clinic.
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- Address 175, Gali Number 7, Barkat Nagar, Tonk Phatak, Jaipur
- Email arunpartani@gmail.com
- Phone +91-9680902501