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Revision Total Knee Replacement

At times, a knee replacement can fail for various reasons and may need to be replaced again. This second operation is called revision surgery. It is a complex procedure in which all or part of the existing knee implants may be removed and replaced with new implants. Some of the common reasons for revision knee replacement are wear and/or loosening of the prosthetic components, infection, instability, bone loss around the prosthetic components, stiffness, fractures, ligament/tendon injuries, malalignment, and maltracking of the knee cap.

Below are the before (left) and after (right) X-rays of a 78-year-old male who presented with a painful total knee replacement performed one year prior to his consultation. He was diagnosed with chronic infection and two-stage revision surgery was recommended. Patient underwent the first stage procedure consisting of removal of the implants and placement of an antibiotic eluting knee spacer. He was quite satisfied with the outcomes and decided not to undergo the second stage procedure in which the antibiotic eluting spacer is replaced with permanent knee implants.

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Below are the before (left) and after (right) X-rays of a 52-year-old female who presented with a painful revision total knee replacement, inability to bear weight, and numbness along the lateral aspect of her leg. She was diagnosed with malalignment of her knee implants with bony perforation and peroneal nerve compression. Complex revision total knee replacement was performed. She was able to bear weight immediately after surgery and achieved complete pain relief with resolution of her numbness.

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