Hip replacement surgery has become a common and highly successful procedure for people with hip pain and mobility issues due to various conditions, such as osteoarthritis, rheumatoid arthritis or hip fractures. However, in some cases, the original hip replacement may fail or wear out over time, leading to the need for revision hip replacement surgery.
Here, we’ll explore when revision hip replacement surgery is needed, what the procedure involves and the associated risks.
Revision hip replacement, also known as secondary hip replacement, is needed when your original hip replacement implant fails or causes complications.
Several reasons may lead to the need for revision surgery:
Implant wear and tear
Over time, your artificial hip joint may wear out, causing pain, instability and reduced mobility. This can result from normal wear and tear. It is especially common in individuals who have had their hip replacements for many years.
Infection can occur in your hip joint, leading to the need for revision surgery. In some cases, this may involve removing the infected implant and replacing it once the infection is under control.
Your artificial hip components may become loose or dislodged from the bone, causing pain and instability. This can result from various factors, including bone loss or poor implant placement.
Fractures around your implant site can result in the need for revision surgery. These fractures may occur due to a fall, trauma or stress on the hip joint.
Component malposition and recurrent dislocation
Incorrect positioning of the hip implant components during your initial surgery can lead to discomfort, limited range of motion, dislocation and the need for revision surgery.
In rare cases, hip implants are recalled due to manufacturing defects or safety concerns. In these cases, revision surgery is needed to replace the defective implant.
Revision hip replacement surgery is a more complex procedure than the initial hip replacement. It typically involves the following steps:
Before surgery, your surgeon will conduct a thorough evaluation, which may include imaging tests, blood tests and a review of your medical history. This assessment helps determine the extent of the problem and helps plan the surgery.
Revision hip replacement is performed under general or spinal anaesthesia to ensure you’re comfortable and pain-free during the procedure.
Removal of the failed implant
Your surgeon will make a cut (incision), usually along the same scar as your original surgery, to access your hip joint. The failed implant components, including the stem, cup and any damaged bone, will be carefully removed.
In cases of bone loss or damage, your surgeon may need to rebuild or reinforce your bone using grafts or special implants.
New implant placement
Your surgeon will insert new hip implant components, which may include a new stem, socket and possibly a liner. These components are selected based on your specific needs.
Closure and recovery
After implant placement, your incision will be closed and you will be carefully monitored during your recovery process. Physiotherapy and rehabilitation are crucial to help regain the strength and mobility of your hip.
While revision hip replacement can improve your quality of life, it is not without risks. Some potential complications and risks include:
The risk of infection is always present with any surgical procedure. In revision hip replacement, the risk may be higher, especially if infection was the reason for the revision.
The risk of blood clots forming in your legs (deep vein thrombosis) or travelling to your lungs (pulmonary embolism) is a concern after any major surgery.
Nerves around the hip joint can be injured during surgery, leading to numbness or weakness in your leg.
There is a risk of your hip joint dislocating or becoming unstable after revision surgery, especially if there is a significant amount of bone loss.
New hip implants can also fail or wear out over time, potentially leading to further revisions in the future.
Recovery from revision hip replacement surgery is often longer and more challenging than the initial hip replacement, and you may not achieve the same level of function as before.
It is essential to work closely with your healthcare team to understand the potential risks and benefits of having revision hip replacement surgery in your particular circumstances. This will help determine the appropriate course of action.
While revision surgery can provide you with relief from hip pain and improve your mobility, it’s not without its challenges and risks. You should carefully consider all your options and consult with your orthopaedic surgeon to make an informed decision about your hip health and quality of life.
Mr Vikas Vedi is a Consultant Orthopaedic Surgeon at Spire Thames Valley Hospital, specialising in hip and knee surgery, joint replacement, revision surgery, and sports injuries to the hip, knee, foot and ankle. He has expertise in minimally invasive joint replacement surgery of the hip and knee, arthroscopic knee surgery and soft tissue conditions around the hip and knee. Mr Vedi is also one of the UK's lead surgeons in the Rapid Recovery Programme for joint replacement surgery — a patient-focused approach to the management of hip and knee replacement patients aimed at improving patient experiences and speeding up rehabilitation. He is a key opinion leader in the use of biologics for orthopaedic conditions.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.