Our Summary

This study looked at how people who needed a second knee replacement surgery (a “revision knee replacement”) felt about the process. The researchers interviewed 15 patients who had this kind of surgery in the UK for non-emergency reasons, like worsening arthritis or a loose artificial joint.

The interviews showed six main themes:

  1. Patients often “soldier on,” or deal with their problematic knee for a while before seeking help.
  2. They found it difficult to navigate the healthcare system.
  3. They felt they knew their own knee best.
  4. Their expectations from the surgery changed over time.
  5. They felt they weren’t the same person they used to be.
  6. Even after surgery, they weren’t sure about the future.

The study concluded that having a problematic knee replacement and needing a second surgery has a big impact on patients’ lives. It suggested that these patients need help getting care and assessments, as well as long-term mental and physical support before and after their surgery.

FAQs

  1. What were the main findings from the study on patients who needed a second knee replacement surgery?
  2. What were the main difficulties faced by patients needing a revision knee replacement according to the study?
  3. What did the study suggest for improving the care and support for patients needing a second knee replacement surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about knee replacement is to seek help as soon as they start experiencing problems with their knee, rather than waiting until the pain becomes unbearable. Early intervention can help prevent further damage and improve the success of the surgery. Additionally, patients should actively participate in their healthcare by staying informed, asking questions, and advocating for themselves throughout the process. It is also important for patients to have realistic expectations about the surgery and to be prepared for a potentially long recovery process. Lastly, patients should continue to follow their doctor’s advice and attend physical therapy to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits daily activities, such as walking, climbing stairs, or getting in and out of chairs. They may also have knee swelling or deformity, as well as knee pain that persists even at rest.

Patients with conditions such as osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, or avascular necrosis are often candidates for knee replacement surgery. Other factors that may lead to the recommendation for knee replacement include failed previous conservative treatments such as medications, physical therapy, or injections, as well as a lack of improvement in symptoms over time.

Ultimately, the decision to undergo knee replacement surgery is made on a case-by-case basis, taking into consideration the patient’s overall health, lifestyle, and goals for treatment. It is important for patients to discuss their options with their healthcare provider to determine if knee replacement surgery is the best course of action for their individual situation.

Timeline

Before knee replacement surgery:

  • Patient experiences worsening knee pain and difficulty with daily activities
  • Patient may try non-surgical treatments such as physical therapy or pain medication
  • Patient consults with a doctor to discuss the possibility of knee replacement surgery
  • Patient undergoes pre-operative assessments and tests to ensure they are a suitable candidate for surgery

After knee replacement surgery:

  • Patient undergoes surgery and stays in the hospital for a few days for recovery
  • Patient begins physical therapy to regain strength and mobility in the knee
  • Patient may experience pain and discomfort during the initial recovery period
  • Patient gradually improves over time and starts to resume normal activities
  • Patient continues with physical therapy and follow-up appointments to monitor progress
  • Patient may experience some limitations in movement and activities, but overall experiences improved quality of life and reduced knee pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement surgery, especially if they are considering a second surgery or revision knee replacement, include:

  1. What are the reasons for needing a second knee replacement surgery?
  2. What are the risks and potential complications associated with revision knee replacement surgery?
  3. How long is the recovery process for a revision knee replacement compared to the initial surgery?
  4. What are the expected outcomes and success rates for revision knee replacement surgery?
  5. Will I need physical therapy or rehabilitation after the surgery, and for how long?
  6. Are there any alternative treatments or options to consider before undergoing a second knee replacement surgery?
  7. How will my mobility and daily activities be affected after the surgery?
  8. What can I do to reduce the risk of needing a third knee replacement surgery in the future?
  9. Will I need to make any lifestyle changes or modifications to prevent further complications with my knee replacement?
  10. What long-term support or follow-up care will be provided after the surgery to ensure the best possible outcome?

Reference

Authors: Nicolson PJA, Toye F, Sabah SA, Price AJ, Alvand A, Barker K. Journal: BMC Musculoskelet Disord. 2024 Aug 29;25(1):676. doi: 10.1186/s12891-024-07778-3. PMID: 39210284