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Revision Total Knee Replacement (TKR)

HeRTR Revision surgery is a highly specialized operation to replace worn, loose, infected or failed primary (first time) implants, and in extreme cases, up to multiple revision total knee replacements.


Dr. Lisandro Carbó has extensive experience and a special interest in the field of complex revision surgery, and is a regular guest speaker at national and international medical conferences on topics related to surgical techniques and strategies.


He has specialized in revision knee replacement surgical techniques, and works closely with radiologists specializing in the musculoskeletal system and orthopedic microbiologists for the treatment of this very complex condition. He also gained experience in reconstructive surgery of the knee and extremities in important treatment centers such as the Endo-Klinik in Hamburg, Germany (a world-renowned center for knee revisions for mechanical failure and infections).


Typical symptoms of a “worn out” RTR are pain, edema, mechanical weakness, and discomfort when getting up from a chair or starting to walk.


X-rays are used to see how the primary implant is failing, often as a result of wear of the polyethylene (artificial plastic joint surface), surgical detachment of the knee replacement, or infection of the original joint.


In difficult cases, additional blood tests, scans and sometimes computed tomography (CT) will be used to plan the surgery in detail before the procedure.


Each case is different but, in general, larger knee prostheses (implants) are used with additional stems (to reconstruct the joint and improve ligamentous instability) and other innovative elements such as the use of transplants with bone or ligament grafts from cadaveric donors to massive bone loss; It is also extremely useful to use porous trabecular metal augmentations or femoral and tibial metaphyseal fixation cones to replace bone defects, which guarantee that the prosthesis is completely “fixed” or cemented with good potential for long-term use.


After knee revision surgery, recovery is a little slower than in primary surgery since the intervention can affect soft tissues, muscle and bone more. However, the benefits for the patient will be significant as they improve pain, edema, and mechanical stability of the knee.


Surgeons use different designs and types of implants depending on the individual circumstances of each case, and for Dr. Carbó it is important to describe the expectations and specific process that each patient must follow prior to surgery.

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