Revision Hip Surgery

Revision hip surgery involves replacing, or repairing, a previous hip replacement that has developed problems. This video explains why revision surgery may become necessary, what the procedure involves, and the expected outcomes. A revision hip replacement may be required for several reasons. These include loosening of original components; fracture around the prosthesis; infection in the joint; dislocation that cannot be managed conservatively; or the wear of implant surfaces causing persistent pain. It is important to understand that outcomes from revision surgery are typically not as predictable as those from primary replacement surgery. The procedure is more complex, your original scar extended, recovery lengthened, and complication risk increased. Risks are of infection, dislocation, deep vein thrombosis, pulmonary embolism, leg length discrepancy, neurovascular injury, fracture, implant failure and delayed wound healing. Due to longer surgery duration compared to a primary hip replacement, there are increased risks to the respiratory, cardiovascular and urinary systems. Hence the need for a pre-operative assessment and optimization prior to surgery. Most revision surgery is completed in a single operation. During this procedure, it may be necessary to remove all old implants, then insert new components tailored to you. Removed implants may be sent to a laboratory for analysis, and permission for this will be sought. Occasionally, revision surgery must be performed as a two-stage procedure, typically used when infection is present. During the first operation, I remove the infected implant and thoroughly clean the joint. A temporary spacer containing antibiotics is placed in your hip. In addition, you will receive antibiotics by mouth, or by injection for several weeks to ensure infection has cleared. Once we are confident infection has been successfully treated, you undergo a second operation where the temporary spacer is removed and your definitive hip replacement inserted. Patients undergoing revision surgery may need to observe stricter movement precautions than those who have had primary hip replacement - because of higher dislocation risk. I will advise which precautions apply to your specific situation. Recovery from revision surgery typically takes longer than recovery from primary hip replacement, with your wound taking longer to settle. You may require a longer hospital stay and will need walking aids for an extended period. Sutures or clips will be removed by your GP surgery at two to three weeks, with first review by me at 6 weeks. Earlier review can be arranged if necessary. Before proceeding with revision surgery, you should be fit for surgery and meet the same criteria for lifestyle recommendations as for primary surgery. This includes maintaining appropriate weight, mobility and smoking cessation where applicable. If you are experiencing pain, instability, or reduced function following a previous hip replacement - please contact my secretary, Ms Maya Rahman, to make an appointment.