What is revision hip replacement surgery?

A hip replacement operation, which is an operation to replace a diseased hip joint, is one of the most successful operations a person can have, with a success rate of 95% or higher. Anecdotally, most patients will go on to almost forget about the hip replacement within 3 to 6 months after surgery, having full use of the hip after this time.

However, because the hip replacement is an artificial bearing in the hip, it will eventually wear out. This wearing of the bearing may cause the prosthesis to loosen, may cause pain, and the hip may begin to feel unstable or unreliable. Patients may also experience the leg shortening, the joint clicking or giving way. This will require either new components to be fitted, or an operation called a revision total hip replacement.

Advancements in revision hip replacement

Revision hip replacement surgery has advanced a great deal over the last 5 to 10 years. With these advancements, confidence has also grown amongst surgeons over the long-term outcomes of these revision procedures, meaning they feel more confident in offering primary hip replacements to patients at a younger age then before.

The days that primary hip replacement was postponed for as long as possible, in fear of requiring early revision hip surgery, are numbered.

How is a hip prosthesis repaired?

Reconstruction of the failed total hip replacement is a super specialty which requires a certain amount of artistic ability. Often, the loosening of the failed hip replacement is associated with bone wearing away or losing solidity, either on the socket side or on the side of the femur bone. During revision surgery, bone loss on the femur side can often be addressed much easier than that on the side of the socket.

Often, bone graft or specific acetabular components, made specifically for acetabular (socket) reconstruction may be required.

Considering that the surgery for revising hip replacement is more complex it is not surprising that the procedure often takes longer than the primary total hip replacement. Unfortunately, this also means that complications of surgery can occur more frequently than in primary total hip replacement.

Complications of revision hip replacement surgery

The most common complications faced in revision hip replacement surgery include infection, dislocation of the hip joint after surgery, damage to nearby nerves and blood vessels, the development of deep-vein thrombosis, which can lead to pulmonary embolism (PE), problems with restoration of the length of the leg, and rarely fractures to the femur bone during surgery.

Fortunately, when surgery is carried out carefully and expertly these complications are rare.

Recovery from revision hip surgery

The recovery following revision hip surgery varies a little depending on what components have been revised and also the extent of the surgical procedure.

On average, most patients would stay in hospital between 2 to 5 days but sometimes up to a week. Stair walking would be commenced on day one or two. Quite frequently crutches will be used for 4 to 6 weeks.

Driving a car is possible in most cases between 4 to 6 weeks. Most patients will be able to take part in some increased physical activity by three months, this can be longer walks or some chipping and putting for golf players! Most patients should have mostly recovered by between 6-9 months but recovery can continue up to 12-14 months.

For most patients the recovery is slower than for the primary hip replacement. The positive news however, is that 90% of patients can expect their reconstructed hip to last another 10 to 15 years.

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