Primary Knee Implants v. Revision Implants
The initial surgery to implant a prosthetic knee device is known as Primary Knee Replacement, while the second surgery needed to replace this device is known as Revision Knee Replacement.
While these surgeries are similar and may involve many of the same components, it’s important to recognize they can have different levels or risk and patient outcomes.
First, a revision knee surgery is a longer, more complicated procedure. Whereas in Primary Knee Surgery the doctor only has to form your existing bone to accept the knee implant, a Revision Surgery requires removal of the first implant, repairing tissue damage, then refitting a new device.
Often, the removal of the first implant leaves less bone for surgeons to work with, so they must form the remaining bone, graft new bone from donors or other areas of the body, or use augment pieces to fill areas of missing bone.
Second, the knee implant components used in a revision surgery may be different than those used in a primary surgery to account for lost bone space. Examples are longer stems that penetrate deeper into the femoral or tibial bones for added strength.
Finally, the revision procedure as a whole takes more planning prior to surgery, specific tools not used in primary knee replacements, and greater skill by surgeons and operating room support staff.
Doctors note that, while primary knee replacements are intended to last around 20 years, revision knee replacements often only last about half that long. Patients may also experience some lingering pain and restricted range of motion. This is due to the added scar tissue, risk for complications and overall trauma to the surrounding area.
Despite this, the overwhelming majority of patients undergoing revision surgery have positive results. Most report less pain, greater mobility and more stability than they had before the procedure.