Revision Total Knee Replacement

Revision TKR is a highly specialised operation to replace the worn, loose, infected or failing primary (first time) or in extreme cases even multiply revised TKR.

Mr Chapman-Sheath has a particular expertise and specialist interest in the field of complex revision surgery and regularly lectures at both National and International surgical conferences on the techniques and surgical strategies involved.

He has been highly trained in the management of infected knee replacement revision techniques – liasing closely with specialist musculoskeletal radiologists and orthopaedic microbiologists in managing this challenging problem. He has also gained further surgical experience of massive knee and limb reconstructive surgery working at major cancer treatment centres at the University of Oxford, UK and University of British Columbia, Vancouver, Canada.

Typical symptoms of a ‘worn-out’ TKR include pain, swelling, mechanical giving way and pain on starting an activity such as getting out of a chair or starting to walk.

X-Rays will be used to see how the primary implant is failing, often as a consequence of wear of the polyethylene (plastic artificial joint bearing), surgical malalignment of the original knee replacement or infection of the artificial joint.

Additional blood tests, ‘bone scans’ and sometimes Computerised Tomography (CT) scans will be used in difficult cases to plan the surgery in fine detail before the operation day.

Each case is different but in general, a larger knee prosthesis (implant) is used with additional stems (to help rebuild the joint and improve ligamentous instability) and innovative solutions involving porous Trabecular Metal augments to replace any bone defects - ensures a fully ‘fixed’ or cemented prosthesis with a good long term potential.

Following knee revison surgery patients should recover a little more slowly than the primary TKR operation  - as additional and more extensive surgery to both the soft tissues, muscle and bone is often required, but you will still gain greatly from the operation experiencing significant improvements in pain, swelling and mechanical stability of your knee.

Surgeons use different designs and types of revision knee implants depending on individual circumstances and I will discuss your individual operation plan and requirements with you in the Outpatient Clinic setting prior to the operation day.

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