Some patients may ask, when do I actually need to go ahead and go forth with the surgery for revision knee replacement? If your pain is due to just weakness as we discussed, usually physical therapy and the strengthening exercises will prevent you needing that. Sometimes after a total knee replacement, multiple years down the road, your ligaments can kind of stretch out and the knee may not be as stable as it was before, meaning when a surgeon kind of feels your knee it may feel a little looser to them. Some patients tolerate that well, other patients don't. So if you've done your physical therapy and it's still not getting better, that's one reason to need a knee revision surgery.
Another reason is that long-term, 15, 20 years down the road, sometimes the plastic piece in between the two metal components, the polyethylene, can wear out. During that surgery we go and just simply replace that polyethylene with a new polyethylene.
Other reasons that you may need a revision surgery, and it would be more obvious in an office setting, is either loosening of the components themselves or an infection. So new onset pain and swelling around the knee when previously you were doing well can be a sign that you may have an infection in your knee or that one of the components is loose. In the office, we can look at you, do a physical exam, even aspirate some fluid or draw some fluid out of your knee with a needle and then send it off to a lab to test for those things. We can also get different blood tests to test for infection as well.
