While knee replacement operations are usually highly successful, prosthetic knees have lifespans and may need to be replaced over time. If your artificial knee is beginning to wear out, you might need revision knee replacement surgery to replace all or part of your existing knee implant.
Revision knee replacement is a more complex procedure than a primary knee replacement, requiring specialist expertise, advanced implants, and careful preoperative planning. At Ramsay Health Care, our knee replacement revision specialists and experienced orthopaedic surgeons perform revision procedures across multiple hospital locations in the UK, supported by a multidisciplinary team including specialist physiotherapists, to give you the best possible outcome.
Here, we’ll explain why you might need revision knee replacement surgery, how the operation is performed, and what you can expect for recovery.
Book an appointment to discuss knee replacement revision surgery
What is revision knee replacement surgery?
Revision knee replacement surgery is a procedure performed to remove and replace part or all of an existing knee replacement implant that has failed or is no longer functioning properly.
When your knee is first replaced, one to three compartments of the knee are removed and substituted with prosthetic components:
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A femoral component attached to the thigh bone (femur)
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A tibial component attached to the shin bone (tibia)
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A patellar component that replaces the surface of the kneecap
A total knee replacement involves replacing all three compartments, while a partial knee replacement involves replacing only one compartment.
With revision knee replacement surgery, you may need one component replaced or all three. In both cases, surgery is generally a more complex procedure than a first knee replacement. The operation often takes longer, may require specialist implants, and is more complicated for the surgical team. In some cases, bone grafting is needed to rebuild areas of bone loss around the joint.
Revision knee replacement surgery may be recommended if your original knee replacement has failed due to wear, loosening, infection, or another complication.
Why might I need revision knee replacement surgery?
You’ll need revision knee replacement surgery if your knee implant fails or if there’s another serious issue with it. The most common reasons people need knee revision surgery include:
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Implant loosening: Over time, the bond between an implant and the surrounding bone can weaken (aseptic loosening), causing pain and inflammation, and impairing mobility.
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Wear and tear: Knee components can wear out or break over time and will need to be replaced. In some cases, the plastic spacer that sits between the metal components of a knee prosthesis can gradually wear down, releasing tiny particles that can trigger inflammation and cause bone loss around the implant (osteolysis).
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Instability: Damage and degradation of the soft tissue around your knee joint can reduce stability, making the knee feel unstable or even causing it to give way during movement. Revision surgery can help restore stability and improve function.
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Stiffness: Some patients develop significant scar tissue around the knee joint after replacement surgery, impeding movement and causing stiffness. In some cases, a procedure called manipulation under anaesthesia (MUA) may be attempted first to break down scar tissue and improve the range of motion. If stiffness persists despite physiotherapy, MUA, or other non-surgical treatments, revision surgery may be recommended.
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Fracture around the implant: A fall or injury can sometimes cause a fracture in the bone surrounding a knee replacement implant. Or a fracture may occur due to ageing or conditions like osteoporosis. Knee replacement revision surgery may be needed to repair the damage and restore stability.
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Infection: Although relatively uncommon, infections can develop around a knee replacement component months or even years after knee replacement surgery. Treatment may involve removing and replacing the implant, either during a single operation or as a two-stage procedure with a period of antibiotic treatment in between.
Certain factors can increase the likelihood of requiring knee revision surgery, including:
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Having a knee replacement at a relatively young age (under 55) means your implants are likely to wear out during your lifetime
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High activity levels
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Previous knee problems
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An illness or condition that affects your bones or joints, like osteoporosis
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Obesity
What does revision knee replacement surgery involve?
The details of revision knee replacement surgery will vary from patient to patient, but most will involve the following:
Before your knee replacement revision surgery
Your treatment with Ramsay will begin with a consultation with one of our consultant orthopaedic surgeons. They’ll talk to you about your knee, assess your symptoms, and investigate the cause of your knee replacement failure.
Your surgeon may schedule one or more imaging scans to help with the diagnosis. This could be an X-ray to assess the position and condition of the implant and the surrounding bones, a CT (computed tomography) scan, or an MRI (magnetic resonance imaging) scan if they need to see more detail, including soft tissue detail. You may also have a blood test if infection is suspected or a joint aspiration where fluid is removed from the knee and analysed.
Your surgeon will use the above information to decide whether or not revision knee replacement surgery is right for you and how to plan the procedure. This includes deciding whether a bone graft will be required.
We’ll also give you pre-operative instructions before you come to us for your knee surgery. We’ll explain when to stop eating and drinking before the procedure, the clothes to wear, any medication to stop taking, and what to expect on the day of your operation.
During your knee replacement revision surgery
Revision knee replacement surgery is performed under either a general anaesthetic or a spinal anaesthetic.
Your surgeon will usually reopen the original surgical incision, although the scar may need to be extended to provide better access to your knee joint. The failed implant will be carefully removed, and the remaining bone will be prepared to accept the new prosthetic components. If there’s been bone loss around the old implant, this may be treated using metal augments, bone grafts taken from your own body (autografts), or donor bone grafts (allografts).
Specialist revision implants will then be inserted into your knee. These often include longer stems that extend further into the bone to provide additional stability and support.
The procedure typically takes between two and three hours, although more complex cases may take longer.
After your knee replacement revision surgery
Recovery times are generally longer than after a primary knee replacement, as the operation is usually more extensive.
Most patients stay in hospital for between three and seven nights after their surgery. You’ll usually begin walking with the help of a physiotherapist on the first day after your procedure, using crutches or a walking frame for support. Gentle movement will help with healing and can reduce the risk of some complications, including blood clots.
You should expect to experience pain and swelling after your operation. You’ll be advised on how to manage this, which will typically involve pain medication. We’ll also explain how to take care of your surgical wound.
Physiotherapy will play a vital role in your successful recovery and will focus on:
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Restoring range of movement
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Building strength around the knee
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Improving balance and mobility
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Practising everyday activities, such as climbing stairs
At Ramsay Health Care, our experienced physiotherapy teams will support you throughout your recovery with personalised rehabilitation programmes designed to help you regain confidence and mobility.
Knee replacement revision surgery recovery times
Patients will recover from knee replacement revision surgery at different rates. Your personal recovery will depend on how extensive your surgery was, your age and condition, and how well you stick to your recovery plan and rehabilitation. Most patients generally experience the following recovery timeline:
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Week 1: Early recovery at home: You’ll focus on rest and recovery, walking for small stints using crutches or a frame and performing gentle physiotherapy exercises.
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Weeks 2 - 6: Return to everyday activities: Pain and swelling will recede as you heal. You’ll be able to gradually walk for longer (still using crutches or a frame) and return to daily tasks and light activities.
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Weeks 6 - 12: Ongoing rehabilitation: Your rehabilitation will include progressive strengthening exercises, and you’ll improve balance, mobility, and endurance. You’ll be able to return to more and more daily activities. You’ll usually be able to drive within this period, subject to your consultant's advice and your ability to control the vehicle safely.
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Months 3 - 4+: Full recovery: You’ll see a significant improvement in knee function, with full recovery often taking between three to four months, depending on the complexity of the procedure and your overall health.
Return to work after knee replacement revision surgery
How quickly you can return to work will depend on how well you heal and the job you do. Typically, most patients can:
Risks and complications of knee revision surgery
The majority of revision knee replacement operations are successful. As with any form of surgery, there are some risks. As revision procedures are more complex than primary knee replacements, the risk of complications is generally higher.
Your consultant surgeon will discuss your individual risk profile with you before your surgery, detailing possible complications and the steps to minimise them.
Potential risks and complications include:
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Stiffness in your knee and a continued limited range of motion
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Infection of your surgical wound or your knee joint
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Bleeding around your joint – this usually settles, but it may need draining by your surgeon
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Injury to your nerves resulting in numbness and other nerve damage symptoms
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Implant failure or loosening
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Kneecap dislocation (although this is rare)
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Ligament injuries
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Blood clots forming around the knee, which can potentially lead to deep vein thrombosis (DVT) or a pulmonary embolism
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Fracture of the bone during the fitting of your joint implants
What is the success rate of revision knee replacement surgery?
Success rates vary from patient to patient, but revision knee replacement surgery is generally effective at reducing pain, improving mobility, and restoring knee function. Outcomes are typically less predictable than primary knee replacements, and results depend on several individual factors.
Research based on National Joint Registry data suggests that the survivorship of a revision knee replacement is approximately 80% at ten years — meaning most patients can expect their revised implant to remain functioning well for a decade or more.
However, the same research also shows that each subsequent revision carries a greater risk and a shorter expected implant lifespan. If a first revision is required, there is around a 20% chance the second implant will itself need replacing within 13 years. A second revision, in turn, carries a similar risk of requiring further surgery within five years.
The long-term success of knee revision surgery depends on several factors, including:
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The reason for the revision
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The quality of the surrounding bone and soft tissues
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Your age and overall health
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Whether it is a first revision or a subsequent revision procedure
If you had your original knee replacement at a young age or have an active lifestyle, you may be at higher risk of requiring further revision surgery over time. Your Ramsay consultant will discuss the likely outcome of your specific case with you.
Revision knee replacement cost
The cost of a private revision knee replacement operation at Ramsay Health Care will depend on the individual details of your case. After a consultation with one of our orthopaedic surgeons, we’ll give you a personalised quote for your treatment, which will be valid for up to 60 days.
You have a range of options to pay for your revision knee replacement operation, including:
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Self-fund treatment: With our all-inclusive Total Care package, you’ll make a single upfront payment at a pre-agreed price that covers all the treatment you’ll need.
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0% Payment Plans: Spread the cost of your knee replacement revision surgery with our flexible payment plans, with fixed monthly payments made over a time period that suits you.
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Private medical insurance: Your private healthcare insurance may cover your knee surgery with us. You should get written confirmation from your insurance provider before booking your procedure.
Revision knee replacement at Ramsay Health Care
At Ramsay Health Care, our specialist orthopaedic surgeons provide expert, patient-focused care across multiple hospital locations in the UK. Whether you need a first or further revision knee replacement, we will ensure your treatment is tailored to your individual needs and circumstances.
Our knee revision surgeons work alongside on-site physiotherapists and specialist support teams, ensuring a joined-up approach to your care from your initial assessment through to full recovery.
Your Ramsay experience includes:
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Convenient locations across the UK, many with on-site parking. Find your nearest hospital.
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State-of-the-art facilities with access to the latest diagnostic technology, including on-site MRI, CT, and X-ray.
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Comprehensive care and follow-up to monitor your recovery and ensure the best possible outcome for your knee function.
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Dedicated patient support with a friendly specialist team guiding you at every stage of your treatment.
To find out more or book a consultation with one of our knee replacement revision specialists, contact us online or call us on 0808 223 0500.
Revision knee replacement FAQs
