Private Revision Knee Replacement

Revision cases vary a lot, so timing and steps depend on what needs fixing. Many revision procedures take 2–4+ hours of operating time (complex revisions can take longer). Expect additional time at the centre for check‑in, anaesthesia, and recovery.

Basic steps

1. Check‑in and confirmation
   The team confirms the plan, reviews imaging, and does safety checks (correct knee, implants planned, allergies, antibiotics).
2. Anaesthesia
   Usually spinal anaesthesia (numbing from the waist down) with sedation, or general anaesthesia. Many centres use nerve blocks and a multimodal pain plan.
3. Incision and exposure
   The surgeon reopens the prior incision (when possible) and carefully enters the joint.
4. Assess the current implant
   They check which parts are stable, what is loose, and whether there is infection or bone loss.
5. Remove and replace what’s needed
   • exchange the liner or components
   • clean out scar tissue and inflamed tissue
   • address bone loss with augments/cones/grafts if required
   • place revision components (often with stems) and balance the ligaments for stability
6. Test motion and stability
   The knee is checked through bending and straightening to confirm alignment and stability.
7. Close up
   The surgeon closes layers, applies a dressing, and sometimes places a drain depending on bleeding and complexity.
8. Recovery and mobilisation
   You’ll start walking with physio when safe—often the same day or next day. Many revision patients stay 1–3 nights (longer if medically needed or if it’s a staged infection plan).

Your clinic will provide a detailed recovery plan (physio, pain control, wound care, blood clot prevention, and follow-ups). Revision recovery can be slower than a first knee replacement, especially when bone loss, instability, or infection is involved. This is a general timeline, follow your surgeon's instructions.

Week 1

Reality check: Pain, swelling, bruising, and low energy are common. Walking will feel awkward at first.
Goals: Pain control, swelling reduction, safe transfers, and early motion.
Activities: Short walks with a walker/crutches, basic exercises (quad activation, gentle bending/straightening), ice/elevation, wound care, and blood thinner plan (if prescribed).

Weeks 2–4

Still tough, usually improving.
Goals: Better walking tolerance, improved knee straightening and bending, steady routine with physio.
Activities: Physio, daily exercises, gradual increase in walking distance. Many return to desk work with restrictions (timing varies).

Weeks 5–12

The work phase.
Goals: Build strength, balance, and endurance; reduce reliance on walking aids when safe.
Activities: More challenging strengthening, stationary bike if cleared, longer walks, stair practice.

Months 3–12

Long runway, real payoff.
Goals: Maximise function and confidence; return to preferred activities.
Activities: Continued strengthening and low-impact conditioning. Some symptoms (swelling, stiffness) can improve for many months.

Red flags—call your care team or seek urgent help

• fever, spreading redness, worsening drainage, or a wound that opens
• calf swelling/pain, chest pain, or shortness of breath (possible clot)
• sudden worsening pain, inability to bear weight, or a knee that feels newly unstable
• increasing confusion, severe weakness, or signs of dehydration

Exact pricing depends on what type of revision you need (liner exchange vs full revision vs staged infection), implant complexity, length of hospital stay, and where you have it done. Always ask for a written, itemized quote.

Cost in Canada

Typical range: $28,000 - $60,000+

• simpler revisions (like isolated liner exchange) may be lower
• complex revisions with specialized implants, bone loss management, or longer stays can be higher

Cost in the United States

Typical range: CA$42,600 - CA$100,000+
Prices vary widely by hospital, region, insurance status, and implant complexity.

What’s usually included

• surgeon and anaesthesiologist fees
• facility/OR fees and nursing care
• revision implant components (confirm what’s included)
• standard medications and supplies while in the facility
• immediate post‑operative care and follow-up visits (varies)

What’s often not included

• pre‑op imaging (X‑rays, CT, bone scan) and lab work done elsewhere
• infection workup costs (aspiration, cultures, special blood tests) if not bundled
• extended hospital stay, rehab facility stay, or home nursing
• outpatient physiotherapy after discharge
• medications after you return home
• travel and accommodation if out‑of‑province/state

Tips to compare quotes
Ask whether your quote is a global bundle. Request line items for: surgeon, facility, anaesthesia, implant costs, hospital stay/overnights, imaging, follow-ups, and what triggers extra charges.

Choosing your surgeon is a major benefit of pursuing private surgery. Revision knee replacement is more complex than a first knee replacement, so picking the right team matters.

What to look for

Experience and volume (revision‑specific)

Ask how many revision knee replacements they do each year (not just primary knee replacements).

Revision has a learning curve because it often involves:

• removing well‑fixed components without damaging bone
• managing bone loss (gaps/weak areas)
• restoring stability (ligaments may be stretched or deficient)
• dealing with infection workups and complex planning
• using specialised implants (stems, cones, augments, constrained designs)

Also ask about their case mix:

• liner exchange vs full component revision
• instability revisions
• bone-loss revisions (cones/augments)
• periprosthetic fracture cases
• infection cases (one‑stage vs two‑stage protocols, if offered)

Credentials and training

• Verify licensure with the provincial college (CPSO Ontario, CPSBC BC, CPSA Alberta, CMQ Québec, etc.)
• Look for FRCSC orthopaedic surgeons with knee arthroplasty training
• Bonus (not required): surgeons who focus on arthroplasty/revision, publish outcomes, or participate in arthroplasty societies

For more, read our guide: How to Understand Surgeon Credentials in Canada

Clear diagnosis (don’t skip the basics)

A good revision surgeon won’t jump straight to “we’ll revise it.” They should carefully confirm why your knee is failing.

They should be comfortable assessing:

• loosening vs wear vs instability vs stiffness
• whether pain could be coming from hip/spine/nerve issues
• whether there is infection (this is critical)

In many cases, a proper workup includes:

• updated X‑rays (standing alignment views)
• sometimes CT or bone scan/SPECT‑CT
• bloodwork (often ESR/CRP)
• sometimes a knee aspiration (fluid sample) for cell count and culture

Outcomes and safety (ask for real numbers)

Request recent data (or at least typical rates) for their revision practice:

• infection rate
• blood clots (DVT/PE)
• readmissions within 30–90 days
• unplanned return to the OR
• stiffness/need for manipulation (if applicable)
• re‑revision rate (needing another revision later)
• typical pain/function outcomes and return-to-activity expectations

If they can’t share exact numbers, they should still be able to explain their safety systems and what they see most often.

Surgical plan and implant strategy (revision is not “one size fits all”)

Ask:

• What is your working diagnosis and what are the options (liner exchange, partial revision, full revision, staged infection treatment)?
• What implant approach do you expect: standard vs stems, cones, augments, or a more constrained knee?
• How will you restore alignment and stability?
• What is the plan if you find more bone loss or ligament damage than expected?

Infection pathway (this is a big differentiator)

Revision outcomes depend heavily on how infection is detected and treated.

Ask:

• How do you rule out infection before surgery?
• If infection is found during surgery, what happens next?
• Do you use infectious disease support?
• Do you do one‑stage or two‑stage revisions (and in what situations)?

Facility accreditation and safety systems

Choose accredited centres (e.g., Accreditation Canada / CAAASF) with:

• experienced anaesthesia and internal medicine support when needed
• strong sterile processing and infection prevention standards
• access to bloodwork, imaging, and urgent reassessment
• a clear transfer agreement to a hospital for emergencies
• capacity for overnight stays if your case requires it (many revisions do)

Rehab integration (revision recovery is often longer)

You want a written plan covering:

• weight‑bearing status (some revisions require protection)
• physio milestones for motion and strength
• equipment (walker, brace if needed)
• how follow-ups work if you live out of province (virtual vs in-person)
• who to call after hours for wound issues, fever, or sudden swelling

Transparent pricing (revision implants can change the bill)

Ask for an itemized quote including:

• surgeon fee
• facility/OR fees
• anaesthesia
• implant costs (and which revision components are included)
• hospital stay/overnights (and what triggers extra nights)
• follow-ups, imaging, and labs
• what happens financially if the plan changes (e.g., liner exchange becomes full revision)

Questions to ask at your revision knee consultation

Surgeon and plan

• How many revision knee replacements do you do each year?
• How many cases like mine (same problem: loosening/instability/infection/bone loss)?
• What exactly is failing in my knee replacement, and how confident are you?

Safety and infection

• What tests will you use to rule out infection (ESR/CRP, aspiration, cultures)?
• What are your rates of infection, DVT/PE, readmission, and reoperation?

Technique and implants

• Do I need a liner exchange, partial revision, or full revision—and why?
• Will I need stems/cones/augments or a more constrained implant?
• What is your plan if you find unexpected bone loss or instability?

Recovery and aftercare

• How long will I be in hospital?
• When can I walk, drive, return to desk work vs physical work?
• What does physio look like for the first 12 weeks?

Costs and logistics

• What is included in my quote, and what could increase the price?
• If I’m travelling from another province, which follow-ups can be virtual?
• If a complication happens, where am I treated, and how is it billed?

Signals of a high-quality revision knee program

• The surgeon does revision cases regularly, not rarely
• They insist on a proper diagnosis (including infection rule‑out)
• They explain options clearly and set realistic expectations
• The clinic is accredited and has a clear hospital transfer pathway
• You receive a written rehab plan and clear follow-up process
• Pricing is transparent and itemized, including “what if the plan changes” terms