Complete Revision Hip Replacement Surgery

Revision Hip Surgery

Revision Hip surgery generally involves removing some or all of the old components of your hip replacement, followed by re-implantation of new implants.

Careful pre-operative planning is performed in each individual case and the type of new hip replacement determined accordingly.

Risks and Benefits

Overall, revision hip replacement is a reasonably successful operation in modern-day surgery. In my practice, the success rate of a revision hip replacement is 85% or higher. This does vary on a case-by-case basis and I will be happy to discuss this with you during the consultation.

Risks of revision hip surgery are similar to that of total hip replacement but are slightly higher. These include infection (around 2-3%), bleeding, DVT (clots in your leg), PE (clots in your lung), stiffness, loosening, wear, persistent pain (around 1%), medical and anesthetic complications. Precautions order taken to minimize all the above risks e.g. use of antibiotic prophylaxis and specialized laminar airflow theatres to minimize the risk of infection, use of blood-thinning medications, and mechanical methods to reduce the risk of clots, etc. Post-operative exercises are extremely important to decrease the risk of post-operative stiffness.

Rehabilitation and Recovery

You are generally admitted to the hospital on the day of surgery. The average length of a stay in the hospital is 5-7 days. During the hospital stay, a multi-disciplinary team including an orthopaedic team, ward doctor, nursing staff, physiotherapist, and occupational therapist, treats you. Once you and the team are happy with the progress, you are discharged from the hospital.

Post-operative mobilization includes the use of walking aids like walkers or crutches, to begin with. You can subsequently use the walking stick/s until independent mobility can be achieved.

You can expect some swelling and redness around the wound and of the lower leg for a few weeks. Generally, by 12 weeks, functional recovery can be expected in most patients. Most patients can expect to drive around 6 to 8 weeks mark.

• Revision Arthroplasty of the Hip

Frequently Asked Questions

Q1. What is a revision of a total hip replacement?
A revision of a total hip replacement is a complex surgical procedure to remove and replace one or all of the components of a previously implanted artificial hip.

Q2. How successful are hip replacement revisions?
Hip revision surgery is generally successful, but its specific success rate varies by patient and the reason for the revision; while many patients experience significant relief from pain and improved function, outcomes can depend on factors like the cause of failure, the complexity of the revision, and the patient’s adherence to rehabilitation.

Q3. How long does it take to recover from total hip revision?
Full recovery from a total hip revision can take up to 12 months, though many people return to most normal activities within three to six months.

Q4. What are the nice guidelines for revision of total hip replacement?
NICE guidelines recommend that only hip replacement prostheses with projected revision rates of 5% or less at 10 years are considered as treatment options for end-stage hip arthritis.

Q5. How to sleep after hip revision surgery?
To sleep after hip revision surgery, remain on your back with a pillow between your legs for at least the first few weeks to prevent the operated leg from crossing over.

Q6. What is the first stage of hip revision?
The first stage of hip revision surgery is either removing the original components and preparing the site for a new implant (for a single-stage revision) or, in the case of an infection, removing the implant and infected tissue and inserting a temporary spacer to deliver antibiotics for the first of two stages.

Q7. What are the symptoms of need for hip replacement revision?
Symptoms of a hip replacement revision include persistent hip or groin pain, stiffness, limited mobility, instability, a popping or clicking sound, swelling, and redness around the joint, though sometimes symptoms can be more subtle, such as constant fatigue.

Q8. What are the problems with revision surgery?
Problems with revision surgery include increased surgical complexity, such as dealing with scar tissue, poorer bone quality, and potential bone grafting needs, leading to longer operating times, greater blood loss, and more challenging recovery compared to a first-time surgery.

Q9. What is the newest method of hip replacement?
The newest methods of hip replacement focus on minimally invasive surgery, robotic assistance, and custom-designed implants to improve recovery and long-term outcomes.

Q10. What foods should I avoid after hip replacement surgery?
After hip replacement surgery, you should generally avoid highly processed foods, sugary drinks, excessive alcohol, and foods high in sodium, as they can increase inflammation and hinder healing.

Q11. What is the biggest risk after hip replacement?
The biggest risks after hip replacement surgery include blood clots (DVT and pulmonary embolism) and infection, which are serious but treatable.