Revision knee replacement is surgery to replace or reconstruct part or all of a previous knee implant. It is more complex than first-time knee replacement and starts with identifying why the knee is painful, stiff, loose, unstable, or infected.
Revision knee replacement is a second operation on a knee that has already been replaced. The surgeon may exchange plastic, revise one component, revise all components, treat infection, rebuild bone, or use specialized revision implants for stability.
Common reasons include loosening, wear, infection, instability, stiffness, fracture around the implant, or bone loss.
Implant fixation, plastic wear, and bone loss can create pain or instability over time.
Deep infection may require staged treatment and careful coordination with the surgical team.
The knee may feel loose, buckle, or remain stiff because of alignment, sizing, ligament balance, scar, or other causes.
A painful knee replacement should not be revised until the team understands the likely cause. The workup may include X-rays, infection labs, aspiration, CT imaging, and review of prior operative records.
Revision knee replacement begins by determining why the previous knee replacement is painful, loose, stiff, unstable, infected, worn, or failing mechanically. The workup may include weight-bearing X-rays, comparison to prior films, infection bloodwork, aspiration, and sometimes CT or bone-loss evaluation.
The answer matters because a stiff knee, infected knee, loose implant, unstable knee, and fractured bone around an implant are different problems. A good revision plan names the failure mode before choosing the reconstruction and sets realistic expectations for pain relief, motion, bracing, therapy, and follow-up monitoring.
Revision implants may need stems, cones, sleeves, augments, or other tools to manage bone loss and achieve stable fixation.
If ligaments no longer support the knee reliably, the surgeon may choose a more constrained implant design.
When infection is confirmed or strongly suspected, treatment may involve staged surgery and coordinated antibiotic care.
No. Some painful knee replacements do not need surgery, and some pain comes from outside the implant.
Usually yes. Revision may require specialized implants, bone reconstruction, infection treatment, or more constrained components.
Sometimes. The cause and timing of stiffness matter, and a specialist evaluation is needed before choosing treatment.
Prior operative notes, implant information, old X-rays, infection labs, and treatment history can help build the plan.
Procedure pages help patients understand the option. Scheduling helps turn that into a visit with the right TJS specialist, office, and appointment type based on symptoms, imaging, prior treatment, and recovery goals.
This page was reviewed by Total Joint Specialists clinical leadership on May 11, 2026. It is reviewed at least annually and whenever major clinical guidance, source references, or practice facts change.
The content is educational, cites orthopedic society or peer-reviewed sources where relevant, and is not a substitute for an evaluation with an orthopedic surgeon who has reviewed your individual case.
Patient education references used for this page: AAOS Revision Total Knee Replacement, AAHKS Revision Knee Replacement, and AAHKS Total Knee Replacement.
A TJS revision knee specialist can review your implant, symptoms, imaging, and records and explain your options.
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