Revision knee replacement is an operation to remove or correct a knee replacement that has failed and to replace it with new components. Most knee replacements work well for many years, but some become painful, loose, unstable or infected, and a further operation may then be needed.
Revision surgery is usually more complex than a first knee replacement, because of scar tissue, loss of bone around the old implant and, in some cases, infection. Finding the cause of failure before surgery is the most important step, because it decides how the revision is planned.
PMG Hospital (PMG Orthopedic Hospital), Gota, is an orthopedic hospital for revision knee replacement in Ahmedabad. This page explains why knee replacements fail, warning signs, tests, types of revision surgery, implants, recovery, risks and cost factors.
What Is Revision Knee Replacement?
In revision knee replacement, some or all of the components of an earlier knee replacement are removed and replaced. In some cases only the plastic insert is exchanged; in others the metal components on the thigh bone (femur) and shin bone (tibia) are also replaced. Because bone is often lost around a failed implant, revision implants frequently use stems that extend into the bone, and metal blocks (augments), cones or sleeves, or bone graft, to fill the missing bone.
Related pages: Knee replacement·Total knee replacement·Revision knee, hip and shoulder replacement
Why a Knee Replacement May Need Revision
| Cause | What happens | What you may notice |
|---|---|---|
| Infection around the implant (periprosthetic joint infection) | Bacteria settle on the implant | Pain, swelling, warmth, redness, wound discharge, sometimes fever |
| Loosening | The implant loosens from the bone | Pain on standing and walking, a feeling that the knee is not solid |
| Wear of the plastic insert | The plastic wears over time, which can cause bone loss around the implant | Pain, swelling, clicking |
| Instability | The ligaments and soft tissues no longer hold the knee steady | The knee gives way or feels wobbly, especially on stairs |
| Stiffness | Scar tissue limits bending or straightening | Difficulty walking, climbing stairs or sitting |
| Fracture around the implant (periprosthetic fracture) | A bone breaks near the implant, often after a fall | Sudden pain, swelling and inability to stand |
| Component position or kneecap problems | Parts of the implant are not aligned well, or the kneecap does not track properly | Pain at the front of the knee, instability |
Signs That a Knee Replacement May Be Failing
- Pain that returns after a period of good function, or pain that never settled after surgery
- A feeling that the knee is loose or gives way
- Swelling or stiffness that does not settle
- Warmth, redness, wound discharge or fever, which can be signs of infection and need urgent assessment
- Sudden pain or deformity after a fall
Not every painful knee replacement needs revision. Pain can also come from the hip, the spine or the soft tissues around the knee, so a careful assessment is needed before any decision. A revision knee replacement doctor in Ahmedabad first finds out why the knee is painful, because the cause decides the treatment.
Tests Before Revision Surgery
- 1History and examination: details of the first operation, when the pain started, stability, range of movement and the hip and spine
- 2Records of the first surgery: operation notes and the implant details, if available
- 3X-rays: to look for loosening, wear, bone loss, fracture and implant position, compared with earlier X-rays
- 4Blood tests for infection: such as ESR and CRP
- 5Joint aspiration: fluid is taken from the knee with a needle and tested for infection when infection is suspected; antibiotics should not be started before this unless the doctor advises
- 6Other scans: CT scan or other imaging in selected cases, to plan for bone loss and component position
- 7Fitness for surgery: heart, lung, kidney and blood sugar checks, and correction of anaemia and nutrition when needed
Revision Knee Replacement Treatment in Ahmedabad
The type of operation depends on the cause of failure. The main options are similar in any revision knee replacement surgery hospital in Ahmedabad:
| Type of revision | When it is used | What it involves |
|---|---|---|
| Insert exchange or partial revision | Wear of the plastic insert or some types of instability, when the metal components are well fixed | Only the plastic insert, or the insert and one component, is replaced |
| Single-stage revision | Loosening, wear, instability, stiffness or malposition without infection; selected infections | The old implant is removed and the new implant is fitted in the same operation |
| Debridement, antibiotics and implant retention | Early infection (shortly after surgery or of recent onset) with a well-fixed implant | The joint is washed out, infected tissue is removed, the plastic insert is changed and antibiotics are given |
| Two-stage revision | Long-standing infection | First operation: the implant is removed and a temporary antibiotic-loaded cement spacer is placed, with a course of antibiotics. Second operation, usually after some weeks or months: the new implant is fitted once the infection is controlled |
Revision implants may use longer stems for fixation, augments, cones or sleeves to make up for bone loss, and implants with more built-in stability (constrained or hinged designs) when the ligaments are not working. A wider incision is often needed to remove the old components safely.
A revision knee replacement treatment hospital should also be able to treat infection around an implant, including staged surgery and long courses of antibiotics.
Robotic Assistance and Tissue-Sparing Choices in Revision Surgery
Revision surgery is planned individually. Robotic systems are designed mainly for first knee replacements; at PMG Hospital they are combined with the subvastus approach and surgery without a thigh tourniquet under the name "TriNova". In revision surgery, the subvastus approach or surgery without a tourniquet is used only where the specific case allows. Many revisions need a wider exposure, and the reconstruction is guided mainly by the bone loss and the revision implant system.
First Knee Replacement and Revision Surgery Compared
| Feature | First (primary) knee replacement | Revision knee replacement |
|---|---|---|
| Starting point | A worn natural knee | A failed implant, scar tissue, possible bone loss or infection |
| Exposure | Standard | Often wider |
| Implants | Standard components | Revision components with stems, augments, cones or sleeves; sometimes constrained or hinged designs |
| Operating time | Usually about one to two hours | Usually longer |
| Recovery | Usually weeks to a few months | Usually longer, often several months up to a year |
| Risk of complications | Lower | Higher |
Risks and Possible Complications
Revision knee replacement carries higher risks than a first knee replacement. The surgeon explains these risks before taking consent.
- Infection, including infection that returns after treatment for an infected implant
- Bleeding, sometimes needing blood transfusion
- Blood clots in the leg veins or lungs
- Stiffness or instability of the knee
- Fracture of the bone during or after surgery
- Wound healing problems, especially when there is scarring from earlier operations
- Injury to nerves or blood vessels, which is rare
- Loosening or failure of the new implant, which may need further surgery
- Continuing pain in some patients
- Rarely, fusion of the knee or amputation, in severe, uncontrolled infection
- Anaesthesia-related and general medical risks, such as heart, lung or kidney problems
Recovery After Revision Knee Replacement
| Time | What usually happens |
|---|---|
| First days | Hospital stay, pain control, first movement and walking with support when allowed |
| First few weeks | Walking with support, wound healing, physiotherapy |
| 6–12 weeks | Gradual return to daily activities as strength improves |
| 3–6 months | Continued rehabilitation and improvement |
| Up to a year | Further improvement, depending on the case |
This is a general guide. Some patients need to limit weight on the leg for a period, for example after bone grafting or fracture fixation. Recovery depends on why the first implant failed, the bone loss, whether infection was present and the patient's general health. After a two-stage revision, recovery includes the period between the two operations.
How Long Does a Revision Knee Implant Last?
Revision implants can work for many years, but on average they do not last as long as a first knee replacement, and the chance of needing further surgery is higher. How long they last depends on the reason for the first failure, the bone quality, whether infection was present, and the patient's weight and activity. Regular follow-up visits and X-rays help to detect problems early.
Revision Knee Replacement Surgery Hospital in Ahmedabad
Before choosing a revision knee replacement hospital in Ahmedabad, check that the treating surgeon is a qualified orthopaedic surgeon with valid medical council registration and experience in revision surgery, that tests for infection (including joint aspiration and microbiology) are available, which revision implants can be used, whether blood transfusion and intensive care are available, what physiotherapy and follow-up are provided, and what the written estimate includes.
Revision Knee Replacement Surgery Cost in Ahmedabad
- The reason for revision and the extent of bone loss
- One operation or two (for example, two-stage revision for infection)
- The revision implants, augments, cones or bone graft needed
- Length of hospital stay, room category and any intensive care
- Antibiotics and other medicines
- Other medical conditions, physiotherapy and follow-up
A written, itemised estimate can be requested from the hospital after assessment.
Insurance
- Medically necessary knee replacement is generally covered under health insurance policies, subject to policy terms, waiting periods and insurer approval
- Some policies have limits on room rent or implant costs; check these with your insurer before surgery
- Ask the hospital whether cashless treatment is available with your insurer, and which documents are needed
Some insurance policies have specific terms for revision surgery. Check your policy and arrange pre-authorisation before planned surgery.
Revision Knee Replacement Doctor in Ahmedabad
Revision knee replacement is performed by an orthopaedic surgeon who works in joint replacement, usually with further training in revision surgery. Because a knee replacement can fail for more than one reason, several doctors may be involved at different stages:
| Doctor | Role in revision knee replacement care |
|---|---|
| Family physician or the surgeon who did the first operation | First assessment of a painful, stiff or unstable knee replacement; referral when revision may be needed |
| Orthopaedic (joint replacement) surgeon | Finds the cause of failure, plans the type of revision and the implants, and performs the surgery |
| Radiologist | Reports the X-rays and CT scans, and may perform image-guided joint aspiration |
| Microbiologist | Identifies the organism in an infected knee and guides the choice of antibiotics |
| Infectious diseases physician | Advises on long antibiotic courses in difficult infections, at some centres |
| Anaesthetist | Checks fitness for surgery, gives the anaesthesia and plans pain relief |
| Physician | Manages diabetes, heart, kidney and other medical conditions before and after surgery |
Revision Knee Replacement Surgery Doctor in Ahmedabad
Revision surgery is planned around the reason the first implant failed, so it is reasonable to ask your revision knee replacement surgery doctor in Ahmedabad a few specific questions before giving consent:
- What is the cause of failure in my knee, and which tests confirmed it?
- Has infection been ruled out, and was a joint aspiration done?
- Will this be an insert exchange, a single-stage revision or a two-stage revision?
- How much bone loss is there, and will stems, augments, cones, sleeves or bone graft be needed?
- Will a constrained or hinged implant be needed to keep the knee stable?
- How much weight can I put on the leg after surgery, and for how long will I need a walker or crutches?
- Is a blood transfusion likely, and how will blood clots be prevented?
- How often will I need follow-up visits and X-rays in the long term?
Revision Knee Replacement Treatment Hospital in Ahmedabad
Revision knee replacement needs more resources than a first knee replacement, so the hospital should be able to investigate the cause of failure, carry out complex surgery safely and support a longer recovery. These are the facilities that matter most:
| Facility | Why it matters |
|---|---|
| Operation theatre with strict infection-control practices | Infection is a common cause of failure and a risk in every revision |
| A range of revision implants, including stems, augments and hinged designs | The full extent of bone loss and instability is sometimes clear only during surgery |
| Laboratory and microbiology tests | Joint fluid and tissue samples confirm or rule out infection and guide antibiotics |
| X-ray and access to CT scan | Shows loosening, bone loss and implant position for planning |
| Blood transfusion support | Revision surgery can involve more blood loss than a first operation |
| Access to intensive care for high-risk patients | Some patients need close monitoring after long surgery |
| Physiotherapy | Recovery after revision is longer and needs supervised rehabilitation |
The facilities available at PMG Hospital are listed further below on this page.
Treating Surgeon
At PMG Hospital, revision knee replacement is performed by:
| Detail | Information |
|---|---|
| Name | Dr. Hiren Patel |
| Qualification | MS (Ortho), B.J. Medical College, Ahmedabad |
| Specialty | Orthopaedics |
| Designation | Director & Head Joint Replacement Surgeon, PMG Hospital |
| Registration status | Registered Medical Practitioner |
| Registration number | Gujarat Medical Council Reg. No. G-20583 |
| OPD availability | Monday to Saturday, 10:00 AM - 8:00 PM |
Facilities at PMG Hospital
- Orthopaedic OPD, Monday to Saturday
- Emergency and trauma care, 24×7
- Orthopaedic physiotherapy centre
- Robotic-assisted knee replacement system (ROSA Knee System)
Frequently Asked Questions
When should I see a doctor about a problem with a knee replacement?
See an orthopaedic surgeon if a knee replacement that was working well becomes painful again, feels loose or gives way, becomes stiff or swollen, or if there is warmth, redness, wound discharge or fever. Fever, a red, hot knee or discharge from the wound needs urgent assessment.
What is revision knee replacement?
Revision knee replacement is an operation to remove or correct a failed knee replacement and replace it with new components. Sometimes only one part, such as the plastic insert, is changed; sometimes the whole implant is replaced. It is usually more complex than a first knee replacement.
Why do knee replacements fail?
Common causes include infection around the implant, loosening of the implant from the bone, wear of the plastic insert, instability of the knee, stiffness, a fracture around the implant, and incorrect position of components. Finding the exact cause is essential before planning revision surgery.
How is an infected knee replacement treated?
It depends on how long the infection has been present and on the organism. An early infection may be treated by washing out the joint, changing the plastic insert and giving antibiotics while keeping the implant. A long-standing infection is often treated in two stages: the implant is removed, a temporary antibiotic-loaded spacer is placed and antibiotics are given, and a new implant is fitted later. In selected patients, the infected implant is removed and a new implant is fitted in the same operation (single-stage revision).
Is revision surgery riskier than the first knee replacement?
Yes. Revision surgery usually takes longer and carries a higher risk of infection, blood loss, stiffness, instability and further surgery than a first knee replacement. Careful tests before surgery, planning for bone loss and the right implants help to manage these risks.
How long does recovery take after revision knee replacement?
Recovery is usually slower than after a first knee replacement. Many patients walk with support within the first few days, but full recovery can take several months to a year, depending on the reason for revision, the bone loss, whether infection was present and the patient's health.
How long does a revision knee implant last?
Revision implants can work for many years, but on average they do not last as long as a first knee replacement. How long they last depends on the reason for the first failure, the bone quality, whether infection was present and the patient's activity and weight. Regular follow-up helps detect problems early.
What facilities should a hospital have for revision knee replacement?
It should have an operation theatre suitable for complex joint surgery with strict infection-control practices, a range of revision implants, X-ray and access to other scans, laboratory and microbiology tests, blood transfusion support, access to intensive care, anaesthesia services and physiotherapy. You can ask which facilities are available on site and which are arranged elsewhere.
What decides the cost of revision knee replacement?
The cost depends on the reason for revision, whether one or two operations are needed, the implants and any bone graft or augments, the length of hospital stay, room category, antibiotics, other medical conditions and physiotherapy. Some insurance policies have specific terms for revision surgery, so check your policy. A written, itemised estimate can be requested from the hospital after assessment.
Contact and Location
PMG Hospital
3rd Floor, Athena Avenue, B/H Jaguar Showroom, Nr. Eulogia Inn Hotel, Gota, Ahmedabad, India
- Phone / WhatsApp:
- +91 96627 70141
- OPD:
- Mon – Sat · 10:00 AM – 8:00 PM
- Emergency and trauma care:
- 24×7