Hip replacement revision surgery

Replacing your old hip replacement with a new one

A hip revision is an operation to take out your old hip replacement and replace it with a new one.

It is usually required when the original hip replacement has become damaged or dislodged, or has developed complications.

It is generally advised for hips to be replaced every 10 years, but for some patients this can be required sooner.

There are various reasons a hip replacement might need to be replaced such as:

The components have started to worn out and loosen, thus causing pain and discomfort Infection in the hip replacement
The hip replacement can dislocate repeatedly therefore a revision surgery is necessary to correct this
The patient may sustain a bone fracture around the hip replacement
An infection develops in the hip replacement, therefore a revision surgery is needed to remove it and replace the infected components.

A hip revision surgery will reduce any hip pain or discomfort that you may experience, and improve your ability to walk and move around.

When you meet with your consultant surgeon they'll ensure that you have the opportunity to ask any questions you may have about your hip revision, they'll discuss with you what'll happen before, during and after the procedure and any pain you might have.

Take this time with your consultant surgeon to ensure your mind is put at rest.

Depending on the reason why you need a hip revision, there are certain non-surgical alternatives:

If your symptoms are mild, you may decide to watch and wait for a while, managing the pain with painkillers and using walking aids.
In the case of an infection, antibiotics can sometimes stop the hip replacement failing.
If your hip replacement keeps coming out of joint, you can wear a special brace to stop it from dislocating.
If you have a fracture, you can sometimes be treated with traction.

The surgery can be carried out under either general or regional anaesthetic. You will discuss your options prior to the surgery with your consultant anaesthetist.

The surgery has three stages:

First, the surgeon will make a big incision on the side of your hip and remove the components of your initial hip replacement, making sure there is minimal damage to the bone.
Next, the consultant will replace any bone lost with a bone graft.
Finally, the new replacement will be inserted and fixed into the bone with acrylic cement or special coatings that bond directly to the bone.

The surgery might be more complicated if the bone is thin or broken or if you have an infection.

Any surgical intervention has potential risk of complications such as pain, excessive bleeding, infection in the surgical wound, unsightly scarring, blood clotting, chest infection, difficulty passing urine, heart attack or stroke.

Specific complications of a hip revision surgery are:

Split in the femur
Damage to nerves around the hip
Damage to blood vessels around the hip Infection in the hip
Bone forming in muscles around the hip replacement
Loosening of the joint
Dislocation
Leg length difference

Your consultant will advise you of all the potential complications and risks ahead of your surgery.

Please keep in mind that a hip revision or total hip replacement can fail with time.

After the surgery you will be required to stay in the hospital for about 2 to 4 days.

Once home, you may need to take painkillers to help manage the pain. Also, you will need to use walking sticks, crutches or a walking frame for about four to six weeks.

Regular exercise following a hip revision should help you to return to normal activities as soon as possible.

Before you start exercising, you should ask a member of the healthcare team or your GP for advice.

It is important to follow the advice your physiotherapist gives you about exercises to strengthen your hip muscles.

Making a good recovery depends on various factors such as age, reason why the revision was conducted, general health state, muscle strength.