This is performed when an existing knee replacement is not doing so well. This can be due to normal wear years after the initial operation or early failure because of problems. These include:
Diagnosing the reason for failure is of the utmost importance and can be achieved by careful questioning, examination and directed investigations. Infection is one of the most difficult problems to treat and sometimes involves at least two operations to put right. Most of the time there is a solution, but sometimes there may not be and it is up to a good surgeon to know the difference between these situations and advise the patient accordingly. This also involves the patient having realistic expectations as to what is possible.
The risks with this kind of surgery are higher and the patient should be followed up indefinitely after the procedure as well as having access to the surgeon at short notice should they run into problems.
This kind of surgery requires careful planning with access to many surgical implants and tools so most of the more complex procedures are carried out in a Specialist Centre by Fellowship trained surgeons with experience in this field.