Revision Total Knee Replacement in Scottsdale, Arizona
Your knee replacement should have given you your life back. If it's causing pain again — you don't have to accept that. Dr. Gough specializes in complex revision surgery and is here to help you find a path forward.
Signs Your Knee Replacement May Need Revision
Knee replacement surgery is one of the most successful orthopaedic procedures performed today. Most patients experience years of pain-free movement. But implants are not permanent — and sometimes complications arise sooner than expected.
If any of the following sound familiar, it may be time to talk to Dr. Gough:
- Pain or aching in or around the knee that has returned or never fully resolved
- A feeling of looseness, instability, or giving way in the joint
- Swelling that is persistent or worsening
- Reduced range of motion compared to earlier in your recovery
- Warmth or redness around the joint that may indicate infection
Dr. Gough will review your imaging and examine your knee during your consultation to confirm whether a revision total knee replacement is the right approach.
- Board-Certified Orthopaedic Surgeon
- Knee Revision Specialist
- Personalized Concierge-style Patient Care
- Scottsdale, Arizona
WHEN A KNEE REPLACEMENT STOPS WORKING
Why Knee Replacements Sometimes Fail
Learn the most common reasons a knee replacement may need revision surgery, from implant loosening and infection to instability, fracture, or wear over time.
Most knee replacements work well for many years, but some can fail over time due to wear, injury, infection, or problems with implant stability.
- Mechanical loosening — the implant separates from the bone over time, most common in younger or highly active patients
- Infection — bacteria in or around the joint cause pain, swelling, and instability that typically require revision to resolve
- Bone fracture — a break near the implant may require a new prosthesis with extended stems for added stability
- Instability — dislocation or partial dislocation of the implant causes unsteadiness and limited motion
- Implant wear or breakage — years of use or high-impact activity can cause components to wear down or fail
SPECIALIZED REVISION CARE
Why Revision Knee Surgery Requires Specialist Experience
Revision knee replacement is more complex than primary surgery, which is why experience, advanced planning, and specialized surgical skill matter so much.
Bone loss, scar tissue, and a well-fixed implant can make revision knee surgery far more challenging than a first-time replacement.
Revision knee replacement is significantly more complex than a primary replacement. The original implant is often firmly integrated with the bone. There may be bone loss in and around the joint. Scar tissue from the first surgery changes the anatomy and limits visibility during the procedure. This complexity is exactly why choosing a specialist matters more for revision surgery than for any other knee procedure.
Dr. Brandon Gough has performed thousands of complex revision surgeries over the course of his career. He has the specialized training, tools, and case experience to handle revisions that many orthopaedic surgeons refer to others. His approach focuses on protecting the tissue and bone that remain, minimizing additional disruption, and placing a new implant that will perform well for years to come.
STEP BY STEP - COMPLEX CASE EXPERTISE
How Revision Knee Replacement Surgery Works
See how revision knee replacement is performed in two phases, from careful implant removal to precise placement of a new, more stable implant.
Revision surgery is carefully planned to remove the failed implant, address bone loss or instability, and rebuild the knee with the right components for long-term function.
Phase 1 - Implant Removal
Dr. Gough carefully removes the existing implant and any damaged, worn, or infected bone tissue. The complexity of this phase depends on how well the original implant integrated with the bone and whether significant bone loss is present.
Phase 2 - New Implant Placement
A new, precisely fitted implant is placed. Depending on the extent of damage and the patient’s anatomy, the revision implant may include:
- Extended stems for additional stability in the femur and tibia
- Bone grafts — from the patient or a donor — to rebuild bone where loss has occurred
- Specialized revision components designed to address instability or significant bone defects
- Implants are most commonly made from cobalt chrome or titanium — materials chosen for their strength, biocompatibility, and ability to integrate with bone tissue over time.
RECOVERY, MILESTONE BY MILESTONE
What Recovery Looks Like After Revision Knee Surgery
See the typical recovery timeline after revision knee replacement, from early healing and protected weight-bearing to steady gains in strength, stability, and daily function.
Recovery after revision knee surgery is usually slower than after a primary replacement, but most patients make steady progress with time, therapy, and the right support.
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Hospital Stay >>> |
Some patients stay 1 to 2 nights following revision surgery. This is slightly longer than primary replacement due to the complexity of the procedure and the need for initial monitoring. |
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Weeks 1-6 >>> |
Restricted weight-bearing. Use of a walker or cane. Pain management as needed. Physical therapy begins. |
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Weeks 6-12 >>> |
Gradual increase in weight-bearing and activity. Continued physical therapy for strength, stability, and range of motion. |
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3 Months >>> |
Most patients are progressing well through rehabilitation. Walking without assistive devices for most daily activities. |
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3-6 Months >>> |
Most patients achieve full functional improvement. With proper care, a revised implant can last 15 to 20 years or more. |
FREQUENTLY ASKED QUESTIONS
Revision Total Knee Replacement FAQs
We know you might have questions about revision knee replacement surgery — here are the ones we get asked the most, answered simply.
Common signs that a knee replacement may need revision include new or returning pain around the knee that wasn\'t present after your initial recovery period, a feeling of instability or looseness when walking or bearing weight, swelling that does not improve with rest or elevation, stiffness that limits your range of motion, a clicking or grinding sensation in the joint, or a visible change in the alignment of the knee. If any of these are present, a consultation with Dr. Gough can determine whether revision is needed and what the right approach is.
Yes --- significantly more so. In revision surgery, the original implant has often fused with the surrounding bone, there may be bone loss that must be rebuilt, and scar tissue from the first procedure changes the anatomy in ways that require experienced navigation. These factors make revision knee replacement one of the most technically demanding procedures in orthopaedic surgery. It is not a procedure that every surgeon performs --- and those who do are not all equally prepared for complex cases. Dr. Gough has performed thousands of revision procedures and handles cases that many other surgeons refer to him.
Recovery from revision knee replacement is similar in structure to your first surgery but typically takes longer depending on the complexity of the case. Some revision patients stay 1 to 2 nights in the hospital rather than going home the same day. Structured physical therapy begins after the initial healing phase and continues for 3 to 6 months. Most patients achieve full functional improvement within 3 to 6 months. Dr. Gough will give you a realistic and personalized timeline before surgery based on your specific case.
With proper care and follow-up, a revised knee implant can last 15 to 20 years or more. Your individual longevity will depend on your age, weight, activity level, the reason for revision, and how well the new implant integrates with your bone. Dr. Gough’s precision-focused technique --- including digital planning and careful tissue management --- is designed to give your revised knee the best possible long-term outcome.
Revision knee replacement requires a specific combination of skills that goes well beyond primary replacement. Removing a well-integrated implant without causing additional bone damage, managing existing bone loss, rebuilding a stable construct in compromised anatomy, and navigating the scar tissue left from prior surgery --- each of these steps requires experience that only comes from a high volume of revision cases specifically. Dr. Gough has that experience. He performs revision surgeries that other surgeons decline and consistently achieves outcomes that restore mobility and quality of life for patients who felt they had run out of options.
There are several reasons a knee replacement may stop functioning well over time. Mechanical loosening --- where the implant gradually separates from the bone --- is the most common cause, particularly in younger or more active patients. Another common cause of revision surgery is incorrect implant size at the time of the initial surgery. Infection around the joint can cause pain and instability. Implant wear from years of use or high-impact activity can degrade the components. Bone fracture near the implant may require revision with extended stems for stability. Instability from loosened or imbalanced soft tissue can also cause the joint to feel unreliable. Dr. Gough will identify the specific cause in your case before recommending a revision approach.