Knee Revision Surgery
Complex revision knee surgery, performed by an Oxford-trained orthopaedic specialist with over 30 years of experience and a focused interest in revision work.
A painful or failing knee replacement is a different problem from a first-time knee. The bone has been operated on before. The tissue around the joint is altered. The original implants need to come out safely before anything new can go in. Revision surgery is technically demanding, and your surgeon's training, experience and judgement matter more than ever.
Dr Elie Khoury completed his fellowship at the Nuffield Orthopaedic Centre in Oxford, one of the world's leading hospitals for complex hip and knee surgery. Knee revision is a focused part of his practice.
What Is Knee Revision Surgery?
Knee revision surgery is an operation to replace some or all of the parts of a previous knee replacement. It's done when the original knee replacement is no longer working as it should. That might be from wear over time, infection, loosening, instability, fracture or another problem.
Knee revision is not the same operation as a first-time knee replacement. It usually involves:
Removing the existing implants safely, with minimal damage to the surrounding bone
Assessing and rebuilding any bone loss that has happened
Choosing revision-specific implants designed to handle altered anatomy
Restoring stability and balance to the joint
A longer, more complex rehab pathway than a first-time replacement
Revision is more technically demanding than the original surgery. It often takes longer, may need specialised implants (sometimes including extension stems and metal augments to support areas of bone loss), and recovery can be slower. The trade-off, when revision is the right call, is restored function and the resolution of pain that non-surgical care can't fix.
When Knee Revision Surgery Is Recommended
Not every painful knee replacement needs revision. Many problems can be managed without further surgery. Revision is considered only when there's a clear clinical reason to operate.
You may be a candidate for knee revision surgery if:
Your knee replacement causes ongoing pain that hasn't responded to investigation and non-surgical care
Imaging shows one or more components are loose
The implant has worn or fractured
Your knee replacement feels unstable, gives way, or doesn't track properly
The joint is, or might be, infected
You've broken a bone around the knee replacement
Your function has steadily declined and other causes have been ruled out
The kneecap (patella) is causing ongoing pain or maltracking
Working out whether revision is the right answer takes a careful assessment. Pain after a knee replacement can come from the implant itself, the soft tissue around the knee, the kneecap, the hip, the back, or a combination. Dr Khoury will review your imaging, your symptoms and your full clinical picture before recommending a way forward. In some cases, the right answer is non-surgical management. In others, revision is the next step.
Dr Khoury's Approach to Knee Revision
Revision surgery is where training, judgement and experience matter most. The decisions made before the operation, especially whether to operate at all, are often the most important.
Dr Khoury's approach is built around three principles.
Diagnosis before treatment A painful or failing knee replacement deserves a thorough workup. That means clinical assessment, imaging, blood tests, and sometimes drawing fluid from the joint to rule out infection. Operating without a clear diagnosis is rarely the right answer. A painful knee replacement isn't the same as a failing one, and the two are managed very differently.
Conservative recommendations, even in revision Revision is a bigger operation than a first-time knee replacement. The decision to proceed should be based on a clear clinical benefit. If your knee can be managed without revision, that's the path Dr Khoury will recommend.
Specialist training and implant expertise Dr Khoury completed his fellowship at the Nuffield Orthopaedic Centre in Oxford, which has a long-standing reputation for complex joint reconstruction. As Chair of the Australian Standards Committee for Surgical Implants, he brings deep knowledge to revision implant selection, including the specialised components often needed when bone is compromised or stability has been lost.
What To Expect - Before, During and After
Before surgery Revision surgery needs more pre-operative work than a first-time replacement. You'll meet with Dr Khoury's pre-surgery team for a careful assessment of your overall health, your previous surgery, and the state of your knee and surrounding bone.
You may be asked to:
Have advanced imaging done. This may include CT scans to check bone stock.
Provide blood tests to screen for infection
Have fluid drawn from the joint if infection is suspected
Stop or adjust some medications
Meet with the anaesthetic team to plan your anaesthetic
Get your home ready for a longer recovery than a first-time replacement
Surgery day Knee revision surgery is performed under general or spinal anaesthetic, depending on what's safest for you. Operative times are generally 2-3 hours.
The hospital stay after revision is usually longer than a first-time replacement, often 4 to 7 days, depending on the surgery and your recovery.
Early recovery (weeks 1 to 12) Recovery from revision is generally slower than a first-time knee replacement. Most patients are up and walking with help within the first day or two. Progressing through walking aids (walker, crutches, cane) takes longer.
Typical milestones:
Weeks 1 to 2: Walking short distances with aid. Basic daily activities. Physio in hospital and at home.
Weeks 3 to 6: A gradual increase in mobility. Slower progress than a first-time replacement.
Weeks 6 to 12: Many patients move from crutches to a cane, with ongoing strengthening.
Full recovery (6 to 18 months) Full recovery from knee revision can take 6 to 18 months, depending on the complexity of the case and your starting point. Many patients achieve excellent function and major pain relief, though recovery is usually longer and less predictable than a first-time replacement. Dr Khoury will give you a realistic view of what to expect for your specific case.
Frequently Asked Questions
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Knee replacements can fail for several reasons. The bearing surfaces can wear. Components can loosen. The joint can become unstable. Infection can develop. A bone around the implant can break. The kneecap can cause ongoing pain or track poorly. Modern knee replacements are expected to last 20 years or more in most patients, but failures do happen.
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Yes. A painful knee replacement deserves a thorough investigation, including imaging, blood tests, and sometimes joint aspiration. Sometimes the cause is clear. Sometimes it takes more work to pin down. Dr Khoury accepts second-opinion referrals for painful knee replacements where the cause hasn't been fully worked out.
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A combination of clinical assessment, imaging (X-rays, sometimes CT or MRI), blood tests for signs of infection, and where appropriate, drawing fluid from the joint. Working out the cause is essential before recommending revision.
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Yes. Revision is more technically complex and has higher rates of complications, including infection and stiffness. The benefits, when revision is the right call, can be significant: pain relief and restored function. Dr Khoury will walk you through your individual risk.
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Longer than a first-time knee replacement. Many patients are doing well by 3 months. Full recovery can take 6 to 18 months, depending on the complexity of the case but Dr Khoury will speak with you about your specific situation and case.
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Yes. To see Dr Khoury, a referral from your GP is required. You can also ask your GP directly to refer you to Dr. Khoury. Once you have it, our rooms will help you book a consultation that suits you.
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Dr Khoury consults at three locations: St Kilda Road Melbourne, the Mornington Peninsula at The Bays Hospital, and Albury at the Gardens Specialist Centre. Our team will help you find the most convenient one.
Dr Khoury’s Approach to Knee Revision Surgery
A painful or failing knee replacement deserves a careful, considered second opinion. Dr Khoury and his team will take the time to understand your history, review your imaging and walk you through the options honestly. Revision is the right answer when the clinical picture supports it, and only then.
To book, you'll need a referral from your GP. If you don't have one yet, your GP can refer you directly to Dr Khoury at any of our three locations.