Knee replacement is a highly effective treatment for arthritis and involves replacing part some or all of the knee’s joint surfaces.

In rare cases, problems may arise after a knee replacement that require surgery to replace part or all parts of the knee replacement. This is called ‘revision surgery’ and is a sub-specialty practice that may require a high level of medical support such as intensive care, as well as a highly experienced surgical and medical team.

Revision knee replacement involves removing and replacing one or more components of a previous knee replacement. It may also involve treating associated problems such as:

• infection

• bone loss

• soft‑tissue loss (skin or muscle)

• instability or mechanical failure.

Because these issues vary widely, revision surgery can range from a straightforward procedure to a complex, multi‑stage reconstruction.

Revision surgery is usually required to treat a complication of the original knee replacement such as:

• wear of one or all the components over time

• fracture of bone around the knee replacement (peri-prosthetic fracture)

• looseness or instability of the knee replacement

• loosening of one or all the components (prosthetic loosening)

• infection around the knee replacement (peri-prosthetic infection)

• progression of arthritis in other parts of the knee joint where there has been a partial replacement performed.

Because revision surgery may be required for many different reasons, the complexity varies greatly:

• Some cases require short, routine procedures

• Others may involve multiple operations, longer hospital stays, and extensive medical therapy

The decision to operate — and the planning required — can be highly complex. Experience in this field is critical to achieving the best possible outcome.

Despite being repeat and sometimes highly complex surgery, revision knee replacement is generally very rewarding for the patient, with improved function, better mobility, reduced pain and enhanced quality of life.

Immediately after surgery

After the operation, you will be taken to the recovery room, where staff will monitor you as you wake from the anaesthetic. You will then return to your hospital room.

Early mobilisation is important. On the day of surgery or the following morning, a physiotherapist will guide you through exercises to begin your recovery. Continuing these exercises in hospital and at home is essential to maximise your result and prevent stiffness.

Patients typically stay in hospital for around five days before returning home or transferring to a rehabilitation facility. A rehabilitation coordinator will discuss your options during your admission.

You will also be taught safe techniques for everyday activities such as bending, sitting, and using stairs.

Mobility and walking aids

You will initially use two crutches or a frame until you can safely progress to one crutch and walk without a limp.

Typical timeline:

• Two crutches: approximately 3–4 weeks

• One crutch (opposite hand): 4–6 weeks

Caring for your wounds

Your dressing must remain clean, dry, and intact for the first two weeks.

• Wash but do not to get the dressing wet.

• If the edges lift, tape them down.

• A small amount of blood staining is normal.

• You may shower but avoid baths or swimming until four weeks after your operation.

• Swelling in the knee and leg is expected—rest, elevate, and ice the knee to help reduce it.

Mr Patten will advise what type of stitches you have. Some require removal at around two weeks; others dissolve on their own.

Managing pain after surgery

Pain is a normal part of the healing process and will gradually improve.

In the early days:

• rest and elevate the leg

• apply ice regularly

• take pain relief as prescribed

You will be discharged with pain medication. For ongoing pain management, please arrange a review with your GP.

If you are worried about your level of pain, contact our rooms for reassurance and to rule out rare complications.

Recovery timeline

• 4 weeks: generally comfortable

• 3 months: mostly recovered

• 12 months: knee may feel fully “normal”

Returning to work

• Desk‑based work: 3–4 weeks

• Manual or labour‑intensive work: 6–8 weeks

Driving

• Right knee replacement: approximately 6 weeks

• Left knee replacement: 3–6 weeks (depending on manual vs automatic car)

Dental work

Before any invasive dental work (fillings, extractions, etc.), advise your dentist that you have a joint replacement, as antibiotic cover is recommended. Your dentist will follow their own antibiotic protocol.

You may not need antibiotics for a routine scale and clean.

Risks and complications

Complications are uncommon but can include:

• superficial wound infection

• blood clots

• persistent knee pain.

Rare complications include:

• injury to nerves or blood vessels

• infection within the joint.