27486 Revision of total knee arthroplasty, with or without allograft; 1 component

Name of the Procedure:

Revision of Total Knee Arthroplasty, with or without allograft; 1 component

Summary

Revision of Total Knee Arthroplasty (TKA) is a surgical procedure to replace or repair one component of a previously implanted knee replacement. This may involve replacing the femoral, tibial, or patellar component of the knee prosthesis.

Purpose

The procedure aims to address issues such as wear, loosening, or damage to one part of the knee prosthesis. The goals are to alleviate pain, improve knee function, and extend the lifespan of the knee replacement.

Indications

• Persistent knee pain following a previous total knee replacement
• Loosening or wear of one component of the knee prosthesis
• Infection around the knee prosthesis
• Instability or mechanical failure of the knee joint

Preparation

• Fasting typically required after midnight before the surgery
• Adjustments to medications as advised by the healthcare provider
• Preoperative assessments such as blood tests, imaging (X-rays, MRI), and evaluation of general health

Procedure Description

1. The patient is given anesthesia (either general or regional).
2. An incision is made over the knee to access the joint.
3. The affected component of the knee prosthesis is removed.
4. The bone is prepared, and the new component is implanted, possibly using an allograft (donor bone tissue) if needed.
5. The surgical site is closed with sutures or staples, and a sterile dressing is applied.

Tools and equipment used include surgical instruments, knee prosthesis components, and possibly allograft material.

Duration

The procedure typically takes 2 to 3 hours.

Setting

The procedure is performed in a hospital surgical setting.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technicians

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Implant loosening or failure
• Knee stiffness or reduced range of motion
• Allergic reaction to anesthesia

Benefits

The primary benefits are pain relief and improved knee function. These benefits can sometimes be realized immediately, but often it takes several weeks to months as recovery progresses.

Recovery

• Hospital stay of 1 to 3 days typically required
• Physical therapy is crucial for optimal recovery
• Pain management through prescribed medications
• Gradual return to normal activities over several weeks to months
• Follow-up appointments with the surgeon to monitor progress

Alternatives

• Conservative management including physical therapy, pain medication, and lifestyle modifications
• Arthroscopic surgery for minor adjustments
• Complete revision of the entire knee prosthesis

Each alternative has its own set of risks and benefits, and the appropriate option depends on the specific condition of the patient.

Patient Experience

• During the procedure: The patient will not feel pain due to anesthesia.
• After the procedure: Expect some pain and swelling, which will be managed with medications. The patient may use crutches or a walker initially. Physical therapy will be required to regain strength and mobility.