Generally, a well performed Total Knee Replacement in a patient 60 or over will last 15 years or more in 80-85% patients. TKRs done in younger patients and in those with significant osteoporosis can fail early. Primary TKR can fail due to various reasons such as

• Wear and tear of the plastic component in the implant
• Aspeptic loosening of the implant from bone
• Infection
• Traumatic injury/ fracture
• Technical issues with primary surgery such as rotational mal alignment.

Symptoms:

• Recurrent knee swelling
• Instability of the knee
• Pain while weight bearing
• Stiffness/ abnormal mobility

Unfortunately, a revision TKR is much more complex compared with a primary TKR. Since the cause of the failure of primary surgery as well as the detrimental effects of a failed joint are both needed to be addressed.

Revision TKR in setting of infection generally needs a two stage surgery. Stage 1 involves removing the original implant, thoroughly cleaning the joint and replacing it with an antibiotic laden cement implant. In about 6-12 weeks, second stage is performed where a new implant which has more constraint than the primary implant and generally has rods fixing it in the femur and tibia, is implanted in. The success rate is dependent on various patient and infection related factors but is roughly about 90%

In cases of aseptic loosening of implants, a singe stage revision is performed replacing the old implants for a revision TKR correcting any specific reason for failure.