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Primary and Revision Total knee replacement

Primary total knee arthroplasty, i.e., abbreviated as TKA, is a preferable procedure, which is favored because of its long-term results. But its complicacy depends on the condition of the patient. These conditions in the patient can be significant coronal deformities, previous surgeries, stiff knee, previous incisions, extra-articular deformities, previous osteotomy around the knee, and genu recurvatum, etc.

Each situation is being analyzed as per the characteristics shown by the patient, his/her pre-operative signs and the recorded outcomes.

Total knee replacement is recommended as one of the most successful methods in the medical world. In most of the cases, people who’re being operated, live a healthier and more comfortable life without severe pain. But, with time, a knee replacement may fail because of many reasons. The major sign that you need a TKA again is when your knee becomes painful and swollen. It starts appearing to be stiff, and it gets tough for you to perform daily activities.

Methodology

If your knee replacement gets failed anyhow, the doctor may recommend you a second operation, i.e., revision total knee replacement. In this surgery, the doctor intends to remove some or almost all the parts belonging to the original prosthesis and then replaces these parts with new ones.

However, both the surgeries, be it primary TKA or revision TKA are performed for the same reason and goal, i.e., to make patient free of chronic pain, and improve the functioning of his/her knee. The only major difference in between revision and primary surgery is that Revision total knee replacement is more complicated and takes comparatively more time while being performed in comparison to the primary total knee replacement.

Surgical Procedure

The primary step for both of the surgeries is that patient has to get admitted in the hospital. After performing the required tests, and getting reports, the patient is given with the suitable type of anesthesia (spinal or epidural) as suggested by the anesthesia team.

While primary total knee replacement is being performed, the knee joint gets replaced with either prosthesis, or an implant, i.e., made up of either plastic or metal components. Though TKA proves to be successful procedure, but with time, sometimes, the problem arises again, which requires replacement of the original components again.
In the revision total knee replacement, sometimes, just one implant of prosthesis is needed, while in some cases all the three components, i.e., tibial, femoral, and patellar are to be replaced.

In the beginning, the doctor follows the line of the incision traced while performing the primary total knee replacement surgery. The incision or cut may prove to be longer than the original one as the old components are being removed during the revision surgery. After making the incision, the doctor removes the kneecap to see the condition of your knee joint, and if your soft tissues are infected or not. Then, the plastic or metal components will be assessed to see which of them are shifted from their positions. The doctor then removes the original implant as well as cement (if installed earlier). After that, the doctor will start preparing the bone surfaces to perform the revision implant.

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