Revision hip replacement surgery

Reasons for revision hip surgery

Among the most common reasons for revision hip surgery include:

• Loosening of the components in prosthetics that were originally cemented in place.
• Wearing down of a prosthetic's plastic components, causing an adverse reaction to the surrounding tissue.
• Recurrent hip dislocation or instability.
• Impingement and pain caused by improper placement of the prosthetic.
• Fracture of the bone surrounding the prosthetic. Depending on the location and severity of the fracture, your doctor may be able to fix it. If not, the prosthetic may need to be replaced.
• Adverse local tissue reaction caused by an outdated metal-on-metal implant that needs to be removed and replaced with a new prosthesis.
• Infection in the bone or tissue near the prosthetic, which generally requires removing the device and curing the infection before implanting a new prosthetic.

Preparing for surgery

Your doctor will use imaging tests and other exams to determine whether some or all of the components in your prosthesis need to be replaced. If the bone and tissue that support the implant are damaged, your surgeon may need to use a specialized implant and other components to compensate for the damaged area.

Revision hip surgery is more complex than your initial partial or total hip replacement. The planning, surgery and recovery processes all take more time and patience.

During surgery

During surgery, your doctor will remove the original prosthesis, prepare the area for the new device, and replace the worn-out, infected, misaligned or otherwise failed implant by:

• Removing the prosthetic components along with any scar tissue or abnormal bone tissue that may have formed since your original surgery.
• If infection is the reason for your revision surgery, your surgeon will likely need to remove the current components and replace them with an antibiotic spacer — bone cement loaded with antibiotics. This requires an additional procedure after the infection is gone to remove the spacer and then place your new implants.
• Securely fit implant components to restore hip function.

Recovering from revision hip surgery

Revision hip surgery almost always requires larger incisions that allow the surgeon to remove the original prosthesis and implant a new one. The removal of built-up scar tissue, additional work to prepare the area for a new prosthetic, and added manipulation to the area during surgery all contribute to a lengthier recovery period. Revision hip surgery also tends to be more painful. Your doctor will work with you to appropriately and adequately manage your pain and discomfort throughout the surgery and recovery process.

As you did with your initial hip replacement, you'll need to complete rehabilitation, including physical therapy, to ensure proper function.

Each revision surgery is unique. Talk to your doctor about your hip issues to decide if, when and what type of revision hip surgery is needed.