Revision Knee Replacement Surgery: Restores Your Stability and Helps You Move Without Pain

Knee replacement surgery can significantly relieve pain and enhance the quality of life for people with severe knee osteoarthritis or serious injuries that impair joint function. However, when a previously implanted knee prosthesis fails or develops complications, a second procedure—known as revision knee replacement—may be necessary. Although revision knee replacement is more complex than the initial surgery, the use of advanced robotic-assisted technology, such as the ROSA Knee System, enhances surgical precision and reduces the risk of complications.

Dr. Premstien Sirithanapipat, a total joint reconstruction surgeon specializing in knee and hip replacement surgery at Vejthani Hospital, explains that, in general, patients who have undergone knee replacement surgery can typically use their artificial joint for many years without needing another operation. However, in some cases, complications may develop with the artificial knee, affecting everyday tasks. When this occurs, revision surgery may be necessary to help restore the patient’s natural movement and stability in walking. Depending on the underlying cause, the procedure may involve either a partial or complete revision.

Reasons why patients may need to undergo revision knee replacement surgery include:

1. Degeneration of Artificial Knee Joint:  Most artificial knees have a lifespan of about 15-20 years, but in some cases, they may deteriorate faster than usual due to heavy use.
2. Loosening of the Artificial Knee Joint: Over time, the bone supporting the artificial joint may lose its density, loosening the joint and causing pain and abnormality in movement.
3. Periprosthetic Fracture: The bone surrounding the artificial joint may be injured or fractured due to accidents, such as a fall.
4. Knee Malalignment and Instability: If the artificial knee is installed in the wrong position from the initial surgery, it may cause imbalanced pressure, leading to instability and faster wear and tear.
5. Periprosthetic Joint Infection (PJI): This is a serious complication that can occur within months after surgery or later due to the spread of infection from another part of the body to the knee joint.

Symptoms that may indicate the need for revision knee replacement surgery: 

1. Chronic knee pain that doesn’t improve with medication
2. Feeling that the knee joint is loose or hearing abnormal sounds during movement
3. Swelling, redness, or inflammation around the knee which could signal an infection
4. Inability to fully extend or fold the knee and bow-legged deformity due to osteoarthritis

If these symptoms occur, the doctor may recommend an in-depth investigation to diagnose and assess the suitability of treatment or the possibility of revision knee replacement surgery.

Revision knee replacement surgery is a highly complex procedure because it involves managing the remaining bone and the appropriate positioning of the artificial joint. Nowadays, technology like the Rosa Knee or CORI robotic-assisted surgery is being used to assist in this procedure. The Rosa Knee or CORI robotic surgical robot consists of two robotic arms that help control and determine the position for shaping the knee surface, measure equipment, and determine the size of the artificial knee. It also has software that helps plan and simulate the surgery in advance, making the procedure more accurate and precise. In addition, with the use of the Rosa Knee or CORI robot, large incisions, like in the past, are no longer needed, and the surgery does not require invasive procedures within the bone cavity, which can cause pain and excessive blood loss for the patient. 

Followings are the benefits of the Rosa Knee or CORI robotic knee replacement surgery:

• High Precision: Robotic arms assist surgeons in performing surgeries with high accuracy, reducing the chances of human error
• Small incisions: The incisions are smaller than traditional surgery
• Less blood loss: Less blood loss compared to traditional surgery
• Minimal pain: Patients feel less pain
• Fast recovery: Patients recover quickly, with a shorter recovery time, and can stand and walk within 12 hours
• Better mobility: Patients regain improved mobility

Although revision knee replacement surgery is crucial for those experiencing problems with their initial knee replacement, having effective surgery from the start may help reduce the need for future procedures.

For more information, please contact

Hip and Knee Center, Vejthani Hospital
Call: (+66)2-734-0000 Ext. 2222, 2223
English Hotline: (+66)85-223-8888