HIP REVISION

Hip Revision Surgery

Hip Revision Surgery is required when either all or part of your hip components need to be revised. This can vary between the need to have a minor adjustment to a full explant in conjunction with replacing substantial bony anatomy

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Total Hip Replacement (THR) procedure replaces all or part of the hip joint with an artificial device (prosthesis) with a plastic liner in between to restore joint movement.

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Why is this needed?

Pain is the primary reason for revision. Sometimes the cause is clearly evident but this is not always the case.

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Dislocation, while less common now to what it was can be a reason for revision surgery. This means that the new hip is “popping” out of where it should be. 

Osteolysis, is where bone loss occurs which causes loosening of either the femoral or socket (acetabular) component. This usually presents as pain but may be asymptomatic. For this reason, you must have your joint followed up for life as there can be changes on X-ray that indicate that the hip should be revised despite having no symptoms.

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Infection usually presents as pain but may present as an acute fever or a general feeling of unwell. You will need to a blood test to confirm the presence of infection.

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Plastic (polyethylene) wear, is one of the less invasive forms of revision where only the plastic insert is changed.

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What happens if there is an infection?

If the loosening of the implant is linked to infection, a period of approximately 6 weeks is often required between the removal of the old implant and the placement of the new one.

During this period, a Spacer, or temporary implant, is fitted to leave the bone time to heal with antibiotics. Once blood tests indicate that the infection has been appropriately treated a decision can be made to proceed with a longer term solution

What happens during the surgery?

This surgery is often but not always more extensive than your previous surgery and the complications similar but more frequent than the first operation. In revision surgery the unexpected can happen and good planning can prevent most potential problems. The surgery varies from a simple liner exchange to changing one or all of the components.

Supplementary augments may need to be used to make up for any bone loss.

What happens after surgery?

After undergoing revision hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. Some of the common precautions to be taken include:

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• Avoid combined movement of bending your hip and turning your foot inwards because it can cause dislocation

• Keep a pillow between your legs while sleeping for 6 weeks

• Never cross your legs or bend your hips past a right angle (90 degrees)

• Avoid sitting on low chairs

• Avoid bending down to pick up things, instead a grabber can be used to do so

• Use an elevated toilet seat

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