Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts, most commonly referred to as a “ball and socket,” that are assembled before and during the operation. After surgery, this ball-and-socket prosthesis restores movement in the hip throughout the life-span of the prosthesis.
Unfortunately not all joint replacements last forever. Very few joint replacements run into early problems. Most joint replacements wear out or fail at a later date, requiring a revision.
The main reasons for needing a revision total hip replacement are:
- The ball and socket joint wears out after many years of use
- Infection of joint replacement
- Dislocation of the joint replacement
- Fracture of the joint replacement or bone around the joint replacement
Revision surgery is more complicated than a primary joint replacement and the nature of surgery required is different in each case and will be tailored to your needs.
Preoperative investigations of patients who may need revision surgery are more extensive than those for patients who will undergo a primary surgery. I will use special radiographic (X-ray) projections, CT scan, or nuclear medicine isotope scan imaging of the hip as necessary to determine position and fixation of the replacement parts (components), and to determine precisely the extent of bone loss around a failed implant. A preoperative aspiration (fluid sample) and/or special blood tests may be needed if infection in the failed hip is suspected.
The duration of surgery, the length of the hospital stay and the post-operative recovery may be longer than for a first (primary) hip replacement.
Depending on the nature of the procedure you may have to protect the new hip from loading, by restricted weight bearing, for a period of 4-6 weeks and sometimes three months, with the help of crutches or a walking frame.
As each case will be highly individual and you will discuss the specific details of your surgery in the preoperative consultations.