The total knee arthroplasty can fail for many different reasons. Early failures and late failures usually have different reasons. Early failures are either infections or mechanical errors during the initial surgery. Late failures are usually the result of long term wear of the polyethylene insert. This wear can cause painful loosening of the components and even lysis of the bone behind the implant.
Crucial is the complete analysis of the mechanism leading to the failure of the joint. Only when the reason or reasons of failure are clear a complete correction of those can be archived. Once the errors are detected planning of the revision implant itself starts. The main difference of the revision implant is the way it is fixed to the bone. While the primary implant is fixed to the surface with bone-cement, the revision implant is usually fitted into the bone-marrow. Whenever possible bone-cement is avoided in revision surgery. Revision surgery itself is complex, special instruments or even computer navigation are needed to restore the original anatomy of the knee.
The postoperative treatment is similar to primary surgeries. Usually full weight bearing, and a complete range of motion is permitted. Early rehabilitation is important to recover as fast as possible. Clinical results of revision surgery should also be similar to the results obtained in successful primary surgery.