Joint replacement · knee
Revision knee replacement
Revision surgery identifies and treats the cause of a failed knee replacement, with reconstruction tailored to bone loss and ligament stability.
General guidance
When it may be considered
- loosening or wear
- instability or incorrect alignment
- infection
- periprosthetic fracture
Individual decision
How suitability is determined
Planning requires the symptoms, clinical findings, radiographs and blood tests to be considered together; CT or joint aspiration may also be needed.
An abnormal scan alone is not an indication for surgery. The symptoms, clinical examination, progression and the patient's goals must be considered together.
Surgical plan
Decisions that tailor the procedure
- ruling out infection and correlating the symptoms with the imaging findings
- identifying which components need to be replaced
- assessment of bone loss and ligament function
- the need for augments and stems, and the degree of implant constraint
Alternatives
What is discussed before surgery
Pain after knee replacement may be caused by infection, instability, stiffness, implant loosening, or a problem in the spine or hip. Non-surgical treatment or monitoring is appropriate only after the cause has been clarified; revision without a diagnosis has unpredictable results.
Before the procedure
Preparation and safety
- bring the operative report, implant labels and serial radiographs, if available;
- do not start antibiotics for an unconfirmed problem unless advised, as they may interfere with the diagnosis;
- tell the medical team about diabetes, anticoagulant treatment, allergies, smoking and any active infection;
- do not stop or change long-term medication without instructions from the medical team;
- plan transport, help at home and any recommended assistive devices.
After the procedure
Rehabilitation
Weight-bearing and mobilisation depend on the reconstruction, components used and bone quality; rehabilitation may be prolonged.
The exact protocol, permitted weight-bearing and follow-up schedule depend on the procedure performed and individual progress.
Informed consent
Risks and limitations
Risks include infection, stiffness, instability, fracture, thromboembolism and the need for further surgery.
No procedure can guarantee complete pain relief or a return to a particular level of activity.
After surgery
Signs that require prompt medical assessment
- fever, discharge, spreading redness or worsening pain at the wound;
- sudden swelling of the calf, chest pain or difficulty breathing;
- uncontrolled pain, new numbness, or a change in the colour or temperature of the limb.
For severe symptoms or an emergency, call 112. The instructions given to you at discharge take priority over the general information on this page.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical sources used for patient information
First step
Consultation, diagnosis and an individual treatment recommendation
This information does not replace a consultation. Surgery is recommended only after the individual benefits, alternatives and risks have been assessed.