Revision Hip Replacement

Loose Hip Replacement

Hip replacements can wear out or loosen and some may eventually need revising. Infection around the hip, often caused by innocuous bacteria that do not form an abscess or illness, can gradually make the hip loosen and begin to cause pain in the joint. The hip can sometimes also become loosened through the wearing down of the bearing surfaces within the hip. Typically patients will feel pain in the groin or thigh, which starts gradually and is often worse on first standing up. If x-rays confirm that the hip is loose or worn, it will need revising.

What happens in surgery?

A revision operation is usually more complex than a first time hip replacement. The old components need to be removed and new, usually larger, ones will be put in their place. Sometimes the bone has been worn away and will need replacing with artificial or grafted bone, obtained from a registered bone bank. Bone graft is perfectly safe from infection risk and encourages what is left of the original n bone to re-grow. The type of replacement used will vary and special components will sometimes be needed. Generally, we try to avoid using bone cement with revisions.

Revised Hip Replacement

If infection is the cause of the loosening, the operation may need to take place over two stages. In the first, the hip and any infected tissue is removed. The second operation, some 6-8 weeks afterwards, completes the insertion of the new hip. During the interval between operations you will be able to go home but will need crutches to get about. Patients generally find it surprisingly easy and comfortable during this time.

After the operation

As the operation is more complex you will be closely monitored in the first day or two, sometimes on the High Dependency Unit. You will probably require a catheter and will generally have to have a post-operative blood transfusion.

The recovery period is likely to be longer than the first replacement, mainly because the muscles take longer to heal as they have been repaired for a second time. You will need to use crutches for longer and it may take up to a year for optimal recovery to be achieved. There is a higher risk of dislocation, fracture, thrombosis and infection following revision surgery, but the overall results are still good with at least 70% of second hips lasting at least 10 years.

Clare Park Hospital | Crondall Lane | Crondall | Farnham | Surrey | GU10 5XX

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