What happens if your knee replacement reaches the end of its working life? Jim Newman explains.
A couple of years ago, I wrote an article about a paper produced by the University of Bristol which found that you could expect most knee replacements to last 25 years. As I said then, this was unquestionably good news, giving encouragement to anyone of any age who feels they may need a knee replacement operation.
As you might expect, though, there are a fair few caveats to that. If you lead an active lifestyle, do a job that’s hard on the knees or are a little on the heavier side, 25 years may be something of a stretch. And even if your knee replacement does last a full 25 years, what happens once that time is up?
Can you replace a knee replacement?
It all comes down to what form your existing knee replacement has taken. If your partial knee replacement (PKR) has reached the end of its working life, a total knee replacement (TKR) is the natural next step and should provide many more years of pain relief and significantly restored function.
Where you already have a TKR, however, options are far more limited. You can’t have a second standard TKR on the same knee. All that’s left is to revise the existing implant. You might see this described as the equivalent of taking your car in for a service but in truth it’s a far more involved process than that – more like having your car stripped down and rebuilt from scratch. Which begs the question, if you have a revision of a knee replacement, how long will that last?
How long do revised knee replacements last?
A new paper published in The Lancet recently has given us a greater understanding of this. The core findings were:
- Males and younger patients are at greater risk of multiple revisions (and we don’t really know why men are affected more than women).
- The time between revisions decreases with each revision. In the study, first revisions were revised again within 13 years (on average). By the time patients had reached their third revision, they could expect to need it revising again after just three years.
In truth, we already knew much of what this study confirmed (although the confirmation is welcome). You can have a knee revised but the chances are it won’t last as long or give you the same type of pain relief and function that your primary one did. That’s why we always say:
- Make sure your first operation is the best operation. Your first knee replacement is the best you will have, so it’s vitally important that, where you are able to choose your knee surgeon, you do so. Look for specialist knee surgeons who perform significant numbers of knee replacements every year, and who have low revision rates. You can do that via the National Joint Registry.
- Don’t rush into it. When you’re suffering the pain of osteoarthritis, it’s extremely tempting to look at a knee replacement as the obvious way of addressing your knee pain. It will certainly do that. But we (surgeons and patients) have to be extremely careful about opting for a knee replacement before exhausting other non-surgical options. That’s particularly the case for younger patients because, as the study shows, once your first TKR reaches the end of the road, every other option will be less effective at preventing pain and protecting function.
Consultant Knee Surgeon at the Yorkshire Knee Clinic
“Mr Newman? He’s a genius in my eyes.”
Glen Jackson, YKC patient
How Will A Knee Replacement Help Me?
What’s the difference between a total or partial knee replacement? How long will your ‘new knee’ last? And what are the risks?
What Is Osteoarthritis?
What does osteoarthritis look like? What are the symptoms? And short of surgery, how do you treat it?