Revision Knee Surgery: Understanding Pain, Recovery and What Happens Next
What Is Revision Knee Surgery?
Revision knee surgery is when a person has a second — or sometimes third — operation to replace part or all of their existing knee prosthesis.
This may be required for reasons such as:
Infection
Loosening of the prosthesis
Fracture around the implant
Mechanical or prosthesis-related problems
Some people may also undergo additional procedures, such as:
Manipulation under anaesthesia (MUA) for stiffness
Arthroscopy to investigate or manage symptoms
These procedures aim to address complications, though like all surgery, they can temporarily increase pain and sensitivity.
Why Pain Sometimes Increases After Further Knee Surgery
Every surgical procedure — even when performed with the intention of improving symptoms — introduces new tissue irritation. This can lead to:
Increased pain
Heightened sensitivity (sensitisation)
Delays in regaining movement
A restart of the healing timeline
Soft tissues typically take 6 to 12 weeks to heal after surgery, and fluctuations in symptoms are common during this phase.
Using This as a Point to Restart Your Rehabilitation
Further surgery can also be a natural point to restart or re-focus your rehabilitation.
Early recovery often centres on:
Allowing surgical tissues to heal
Gradual, paced movement
Addressing sensitisation and pain responses
Rebuilding confidence with activity
Creating a clear and predictable progression plan
This phase may help establish direction and structure after a complex recovery pathway.
What the Evidence Does and Does Not Tell Us
People who had revision surgery (or were awaiting revision surgery) were excluded from the Kneed clinical trial.
This means:
The results of the trial cannot be directly applied to people who have had revision surgery.
However, based on Dr Johns’ clinical experience, the same rehabilitation principles used in Kneed are expected to be suitable for people who have undergone additional or revision procedures.
No other trials exist of how best to treat pain after knee revision surgery.
Important Considerations After Revision Surgery
1. Higher Sensitisation
Sensitisation can be even greater after every new surgery, building over time. This may influence how pain behaves and how quickly someone progresses.
2. Possible Increased Risk of Neuropathy
There may be a greater chance of nerve irritation or injury after additional procedures.
Your GP or surgeon can evaluate:
Sensory changes
Nerve-related symptoms
Signs of neuropathic pain
3. Ensuring the Knee Is Safe to Rehabilitate
Before starting active rehabilitation, it’s important to ensure the knee is:
Free of infection
Structurally stable
Clear of other complications
Your surgeon or GP can guide you on when it is safe to begin structured recovery.
1. How Long Does Recovery Take After Revision Knee Replacement?
Healing of soft tissues generally takes 6 to 12 weeks, although overall recovery timelines vary. Sensitisation and previous surgery may influence the pace of progress. Pain should be reducing by 6 weeks with the aim to be pain free by 3-months and achieve full functional recovery by 6-months.
2. Is Ongoing Pain Normal After Knee Revision Surgery
Some fluctuation in pain is common in the early months due to tissue healing and sensitisation. Your clinician can check for complications if symptoms persist or change unexpectedly. One study showed a high risk of severe persistent pain after knee replacement (50% of people), so don’t wait to recover.
Can Rehabilitation Still Help If I've Had More Than One Knee Surgery?
Yes. While evidence from the Kneed trial does not apply to people who have had revision surgery, the rehabilitation principles used in Kneed are still likely to be beneficial.
