My 67 year old mother is an active woman. She
Last two weeks she got the pain in her left leg between knee and ankle joint portion. We consulted a doctor , after seen the latest X-ray,he told it May “ rotation instability noted in tibial platform.he told the component is more moving towards bone edge “.
We are yet to consult Chief doctor in main hospital. I have attached the recent X-rays for your reference. Meanwhile I have the following questions and appreciate if your prompt and expert answers .
1.Is the Revision knee replacement surgery only option available ?
2. Is the total implant replaced or only the problematic portion alone replaced ?
3. My mom is seeing this problem after 13 years since the surgery On her leg , is it bcoz of improper implant set up or other reasons vary patient to patient ?
4. Is it difficult to do the second time operation when compared to first time knee replacement surgery?is it a complex procedure ?
5. Are doctors in XXXXXXX doing revision of knee replacement or is it a rare case ?
6. How is recovery of a patient after revision of total knee replacement?
7. how the amount of existing bone lose is rectified during revision knee replacement surgery
8. Giver her age even if a portion of knee need to be replaced , should you recommend to go ahead and replace the whole knee?
Total knee replacement is only option.
Thanks for posting your query.
I have seen the attached X-rays.
1)There is instability of the tibial platform for which total revision knee replacement is needed. This is the only option.
2)Total implant needs to be replaced for proper alignment.
3) The reason is the wear and tear of the joint in these 13 years and weakening of the bone due to further osteoporosis. Average life of an implant is 15 years depending on the stress and wear and tear of the knee.
4) The revision surgery is more difficult than the first one and needs an expertise.
5) It is common to do a revision of the replaced knee after every 12-15 years.
6) The recovery is good and depends on the general health of the patient.
7) The bone loss can improve with proper treatment of osteoporosis under the guidance of an orthopedician.
8) The replacement of whole knee is the only option. The life of replaced joint is not more than 16-18 years even if it is handled with utmost care.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
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Wishing you good health.
Dr. Praveen Tayal.
2. Compare with initial total knee replacement, how much would revision cost? Please give me some ballpark number.
3. Given my mom age and I am concerned about bone loss. How is the void filled? Are there any complications in there ? What methodologies used for filling bone loss?
4. With so many advancements in knee replacement now a days , what kind of implant should we choose? We are ok even if it expensive. We want to make sure it lasts for many years .
Thanks for writing again.
1) Usually the implant with a longer stem but of the same material is used as the chances of implant rejection by the body are lesser.
2) The revision knee replacement will be almost same as that of the initial knee replacement. The cost is usually around 2 lakhs depending on the implant and the center.
3) The bone loss is filled with the help of bone graft. The bone is taken from the iliac crest and usually there are no complications.
4) The choice of implant depends on the bone strength and the doctor who is doing the surgery. Usually titanium implants are more comfortable but the average life of the implant is almost similar in all cases.
Hope my answer is helpful.
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