Hip Revision Surgery

If you have had a hip replacement and experienced issues with the implants, you may be a candidate for hip revision surgery. Initial hip replacements are generally very successful for most patients and provide lasting pain relief for many years. However, some patients may need a second hip replacement (hip revision surgery or revision total hip replacement) due to infection, implant wear, or injury. 

After an initial hip replacement, implant problems may develop either soon after the surgery or several years later. If you experience any such issues, it is important to consult an orthopedic surgeon who has experience with hip revision surgery, as it is more complex than an initial hip replacement surgery. At OrthoMed Center, our orthopedic surgeons have the specialized skills and experience to perform hip revision surgery, offering patients the best possible outcomes. 

Most patients do not need a revision procedure after original hip replacement surgery, but for others, hip revision surgery may be necessary due to:

• Loosening of the implant over time – Hip replacement implants usually function well for many years, but the implants can loosen from the bone over time. Patients who frequently participate in high-impact activities or are overweight are more at risk for implant loosening. 
• Wear on the implant over time – The implant’s plastic liner can wear down over time, creating tiny particles that are attacked by the body’s immune system. The immune system can also attack and deteriorate the surrounding bone while trying to eliminate the plastic particles. This condition is called osteolysis. As the bone deteriorates, the implant may become loose. 
• Infection – An infection may occur after the initial hip replacement procedure. An infected hip replacement can cause implant loosening,     pain, instability, and drainage. It is difficult to eliminate the infection in a hip replacement with antibiotics alone, and hip revision surgery is recommended to replace the original implants and clear the infection.
• Fracture - If one or more of the bones surrounding the hip implant are fractured, this may cause the implant to loosen, requiring revision surgery to correct.

Hip revision surgery is considered more complex than the original hip replacement procedure. It, therefore, takes longer for the surgeon to perform the revision procedure.

During the procedure, your surgeon will make an incision in the same location as the original hip replacement surgery to remove the old implants. The incision will be larger than the first time since the implants have to be removed.

An experienced surgeon will act to preserve as much healthy bone as possible while removing the original implants. This process is very time-consuming, especially if bone cement was used to hold the original implant in place. In some cases, your surgeon may need to perform a controlled break of the femur (thighbone) to remove the stemmed implant.

Once the original implants are removed, the surgeon prepares the bones for the new implant. Revision implants tend to be larger than the original implants to make up for any bone loss. Metal augments may also be added to the implant for this reason so that the hip is in proper alignment.

If hip revision surgery is performed due to an infection, the surgeon will wash the bacteria out of the joint and replace the ball and plastic spacer. The patient is then prescribed antibiotics to take for several weeks until the infection clears.

In other cases where all the hip implant components need to be removed due to infection, the surgeon removes the implants and places a temporary spacer in the hip that is treated with antibiotics. The patient is then given intravenous antibiotics until the infection clears. After the infection clears, the orthopedic surgeon schedules another procedure to place the new implants. 

Recovery from hip revision surgery is similar to initial hip replacement surgery, but it may be longer. Patients can expect to be in the hospital for a few days after surgery. 

Upon discharge, patients will need assistance for several days or weeks until they can walk independently. Medications will be prescribed to help with pain, and physical therapy is recommended to help strengthen the leg and restore function in the hip.

Most patients can resume all normal activities within 6-8 weeks of surgery.

Our board-certified orthopedic surgeons are experienced in performing complex hip revision surgery at OrthoMed. If you feel any discomfort with your current implants, contact OrthoMed at (209) 524-4438 to set up a consultation with one of our orthopedic surgeons today. You may also request an appointment online.