Revision Knee Replacement

Revision Knee Replacement

How long do knee replacements last? 

Registry data are very reassuring. From AOANJRR analyses:

• When the Registry looks only at modern knee prostheses that are still in use, 20-year revision rates for commonly used combinations generally sit between about 7% and 14%, meaning 86–93% are still functioning at 20 years.
• In younger patients (<55 years), revision is more likely over a lifetime: around 11% at 10 years and about 15% at 20 years. [aoj.amegroups.org]

The proportion of all knee procedures that are revision operations has fallen over time (from a peak of about 8.8% down to around 7.4% in earlier AOANJRR reports), reflecting better implants and surgical techniques. [aoj.amegroups.org]

In everyday terms:

For the vast majority of people, a modern total knee replacement is expected to last at least 20 years, and for many—especially those having surgery later in life—it will likely last the rest of their life.

AOANJRR 2016: Joint Replacement Outcomes Summary

Treatment

Revision surgery is usually more complex than a first-time (primary) knee replacement because:

• There may be bone loss, scar tissue or weakened ligaments
• Old components need to be carefully removed
• Special implants, stems, augments or bone grafts may be required to rebuild the joint and restore stability

Despite this, revision surgery can still be very successful at:

• Reducing pain
• Improving stability
• Allowing you to return to day-to-day activities

Recovery

You can help your knee replacement last as long as possible by

• Maintaining a healthy weight
• Staying active with low-impact exercise (walking, cycling, swimming)
• Avoiding high-risk activities that may lead to falls or major trauma
• Managing conditions such as diabetes and osteoporosis
• Seeing your GP or surgeon promptly if you notice:
• New or worsening pain
• A sense of instability or “giving way”
• Redness, swelling or warmth that might suggest infection
• A sudden change after a fall

Will I definitely need a revision one Day?

No – most people will never need a revision.

Registry data clearly show that:

• Most total knee replacements are still functioning well 10–15 years after surgery
• Many modern implants continue to perform well beyond 20 years

You are more likely to need a revision if:

• You were very young and very active when your first knee replacement was done
• You develop a complication such as infection, recurrent instability, or a fracture around the implant [PubMed]

Minimising your risk of needing a revision

Prevention is the best medicine and so minimising reversible risk factors prior to surgery is the most important step.

This involves keeping your weight and blood sugars in an acceptable range. Delaying surgery if the skin is injured or you are unwell.

We will council you regarding your risk profile prior to considering surgical options.