Preventing Knee Revision Surgery: Doing It Right The First Time

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No one wants to have their knee replacement fail and be told they need knee revision surgery. Revision surgery is more technically complicated for surgeons, presents longer recovery timeframes for patients, and often has poorer outcomes than original knee replacement surgery.

Many factors contribute to the need for knee revision surgery, but high among them is the wear and tear of the implants themselves. Implants can last up to 20 years but, much like the tires on your car, implants can wear down over time and need to be replaced sooner than anticipated. The time it takes for an implant to wear down enough to warrant revision surgery depends on many factors including the types of components originally implanted, how they were placed in the joint, and your activity level.

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Revisions in the first few years following surgery can be a different matter, potentially attributable to infection, technical errors, a surgeon’s skill level with the procedure itself as well as the hospital in which the surgery occurs. A 2012 study in The Journal of Bone and Joint Surgery showed that patients operated on by surgeons who performed 50 or more knee replacements per year had a lower risk of complications than those who were operated on by surgeons who performed 12 or less knee replacements per year. Similarly, patient outcomes were better when surgeries were performed at hospitals that did more than 200 knee replacements per year.

One way of avoiding the pain and pitfalls of knee revision surgery is to have it done right the first time. That means being an educated consumer and asking questions before your first knee surgery to find the surgeon and hospital that are right for you. To help you in this very important step, Arthritis & Joint Replacement Center of Reading has compiled a list of questions you are encouraged to ask your orthopedic surgeon before choosing the doctor to perform your initial knee replacement surgery. This is not an exhaustive list, but offers the basics:

1. Are you board certified? Are you fellowship trained in joint replacement?

2. How many surgeries of this type do you perform successfully each year?

3. At what hospital(s) do you perform the surgery?

4. What is the average infection rate, both for the procedure and at the hospital where the surgery will occur?

5. What types of complications do you typically see with your joint replacement patients?

6. How long is the surgery itself? What type of anesthesia will be used?

7. How soon after surgery will I be mobile (walking the hospital’s hallways)?

8. What is your post-operative plan to help me recover within a reasonable timeframe?

9. How soon after surgery will I be able to resume regular activities?

10. How will I need to care for myself/revised knee once fully recovered?

Any board certified orthopedic surgeon should be able to answer the above questions fully and to your satisfaction. If you are unsure of any answers you receive, seeking a second opinion from another orthopedic surgeon is always a good idea. Dr. Kevin Terefenko is a fellowship trained, board certified joint replacement surgeon who performs hundreds of joint replacement surgeries each year. To learn what options are available to you, contact Dr. Terefenko at Arthritis & Joint Replacement Center of Reading today.

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Arthritis & Joint Replacement Center of Reading

2758 Century Boulevard, Suite 2
Reading, PA 19610
Phone: 610.376.JOINT • Fax: 610.376.8546

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