Our Summary

This study looks at the reasons why people needed to have their knee replacement surgeries (known as Total Knee Arthroplasty or TKA) redone or revised at a specific hospital between 2010 and 2015. The researchers reviewed all available information from patients’ medical records before, during, and after the revision operation. They also categorized the revisions into two groups: ones that occurred within two years of the initial surgery, and ones that happened after more than two years. Some patients even needed to have their revision surgeries revised.

In total, they observed 312 patients who had 402 revision TKAs. Most of these patients (almost 90%) were referred to this hospital specifically for the revision operation. For most of these patients (almost 72%), this was their first revision surgery after their initial knee replacement. In over 70% of these cases, the revision occurred more than two years after the first surgery. However, some patients (over 28%) had already had one or more revision surgeries before.

The main reason for needing a revision was infection (over 36%), followed by the knee replacement becoming loose (over 21%) and fractures around the artificial joint (almost 14%). This finding - that infection was the most common reason for revisions - was different from previous research that looked at larger populations. This could have implications for how much these procedures cost and how successful they are.

FAQs

  1. What was the main reason for needing a revision of knee replacement surgery in this study?
  2. How many patients in the study required a revision of their Total Knee Arthroplasty more than two years after their initial surgery?
  3. How does the study’s finding that infection was the most common reason for knee replacement revision differ from previous research?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow all post-operative instructions carefully to reduce the risk of infection. This includes keeping the incision clean and dry, taking prescribed antibiotics as directed, and attending all follow-up appointments. It’s also important to stay active and participate in physical therapy to help ensure the longevity and success of the knee replacement.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits their daily activities, have not found relief with other treatments such as medications or physical therapy, and have conditions such as osteoarthritis, rheumatoid arthritis, or traumatic injury that have caused significant damage to the knee joint. It is important for patients considering knee replacement surgery to discuss their options with their healthcare provider to determine if they are a good candidate for the procedure.

Timeline

Before knee replacement:

  • Patient experiences chronic pain, stiffness, and swelling in the knee
  • Patient may have difficulty walking, climbing stairs, or performing daily activities
  • Patient consults with a doctor or orthopedic surgeon for evaluation
  • Doctor recommends knee replacement surgery as a treatment option
  • Patient undergoes pre-operative assessments and tests to ensure they are a suitable candidate for surgery

After knee replacement:

  • Patient undergoes knee replacement surgery, which involves removing damaged cartilage and bone and replacing it with artificial components
  • Patient undergoes post-operative rehabilitation and physical therapy to regain strength and mobility in the knee
  • Patient experiences temporary pain and discomfort during the recovery process
  • Patient gradually improves over time and is able to resume normal activities with reduced pain and improved mobility
  • Patient follows up with their doctor for regular check-ups and monitoring of the knee replacement
  • In some cases, patient may require revision surgery due to complications such as infection, loosening of the implant, or fractures around the artificial joint

What to Ask Your Doctor

  1. What are the potential risks and complications associated with knee replacement surgery?
  2. How long is the recovery process after knee replacement surgery?
  3. What type of physical therapy or rehabilitation will be necessary after the surgery?
  4. How long can I expect the knee replacement to last before needing a revision?
  5. What factors could increase the likelihood of needing a revision surgery in the future?
  6. What steps can I take to reduce the risk of infection after the knee replacement surgery?
  7. What is the success rate of revision knee replacement surgeries at this hospital?
  8. How many revision surgeries have you performed, and what is your experience with this type of procedure?
  9. Will I need to make any modifications to my lifestyle or activities after the knee replacement surgery to prevent complications?
  10. Are there any alternative treatments or procedures that could be considered before opting for knee replacement surgery?

Reference

Authors: Postler A, Lützner C, Beyer F, Tille E, Lützner J. Journal: BMC Musculoskelet Disord. 2018 Feb 14;19(1):55. doi: 10.1186/s12891-018-1977-y. PMID: 29444666