When knee replacement is carried out, it is vital that the components used are put in correctly. This involves making the cuts in the bones correctly and getting the tension in the ligaments around the knee just right; this is called 'balanicng' the knee replacement. If this is not done properlyit can lead to problems. If the knee is too tight, it will lead to stiffness and difficulty in obtaining a full range of movement. If it is too loose it will cause instability and giving way fo the knee. Sometimes these problems can be helped with physiotherapy but sometimes the knee replacement will need revision to balance it up properly. This is an example of a knee replacement carried out by another surgeon where the bone cuts are not in the correct orientation. This led to feelings that the knee had 'never been right', pain and instability when walking and a real loss of confidence.
Revising a knee replacement for instability or stiffness can require quite advanced techniques and components to be used and is best done by a surgeon who regularly performs this kind of surgery. Mr. Miles revises knee replacements on a weekly basis and is familiar with advanced approaches and components. He will discuss the benefits of different components with you in detail in clinic when you are deciding whether to have surgical treatment.
Example of revision knee implants used by Mr. Miles