People who have serious arthritis or joint degeneration often say that knee replacement surgery changes their lives. But, as with any medical treatment, there are some problems that can come up. While most knee replacements are successful and last for decades, a small percentage can fail over time due to infection, implant wear, instability, or other mechanical issues. When this happens, patients are often left wondering: Can a failed knee replacement be fixed? The answer is yes, and in many cases, there are multiple surgical alternatives to consider, including the replacement of total knee replacement components.
Understanding Knee Replacement Failure
A failed knee replacement typically refers to an implant that no longer functions as intended. The failure can happen quickly or slowly, and you might feel like the joint is unsteady, in pain that won’t go away, swollen, or limited in your range of motion. Infections, loosening of the implant, and mechanical wear are among the most common causes of failure.
Sometimes, imaging tests like X-rays, CT scans, or MRIs are used to determine the root cause of the issue. Once diagnosed, your orthopedic surgeon will recommend the most appropriate course of action.
Revision Surgery: The Primary Solution
The most common approach to addressing a failed knee replacement is revision total knee replacement surgery. This involves the removal of the existing implant and the insertion of new components. The procedure is more complex than the original surgery, as it often requires managing bone loss, scar tissue, and weakened ligaments.
The replacement of total knee replacement parts in revision surgery is typically done using specialized implants designed for durability and support. Surgeons may also use bone grafts or metal wedges to restore proper alignment and functionality. Even though the healing process may be harder, many patients feel a lot better and can move around better afterward.
Partial Revisions: A Less Invasive Option
Not all failures require a complete redo. In some cases, only a part of the implant may be damaged or misaligned. For example, if the issue is limited to the polyethylene liner (the plastic cushion between metal parts), surgeons might only replace that component. These partial revisions are less invasive, involve shorter recovery times, and still provide relief if the rest of the joint structure is intact.
Alternatives to Full Revision Surgery
In certain situations, other surgical alternatives may be explored:
- Arthroscopic Debridement: If infection or inflammation is localized, minimally invasive arthroscopy may be used to clean the joint.
- Two-Stage Revision: In cases of severe infection, surgeons may first remove the implant and insert a temporary spacer with antibiotics. A second surgery is performed weeks later to insert a new implant.
- Fusion Surgery (Arthrodesis): If revision surgery isn’t viable—often in cases of multiple failures or poor bone quality—knee fusion may be considered. This locks the joint in a straight position and eliminates pain, but limits mobility.
- Amputation (Rare Cases): As a last resort, especially in cases of repeated infections and no viable alternatives, amputation may be considered, though this is extremely rare and only used when all other options have failed.
What to Expect During Recovery
How quickly a person recovers from a revision or alternative surgery relies on their age, health, and the type of surgery they had. Physical treatment is an important part of recovery because it helps the knee get stronger, more flexible, and work properly again.
It is important to keep in touch with your medical team and have realistic goals. Revisions of knee replacements need more intensive care than the first surgery, and it can take several months to fully heal.
Conclusion
Yes, thanks to improvements in surgery and artificial design, a knee replacement that doesn’t work can often be fixed. Patients can get back to being comfortable and mobile through a full replacement of total knee replacement parts, a partial revision, or other surgical choices. Talking to an experienced orthopedic therapist is the first thing that you should do to figure out the best way to treat your condition.
