Revision Hip Replacement

Revision hip replacement is a complex surgical procedure in which all or part of a previously implanted hip-joint is replaced with a new artificial hip-joint. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities. During total hip replacement the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. After many years, hip replacement implants can wear out for various reasons and may need to be replaced, a surgical procedure known as revision hip replacement surgery.

Indications:

Revision hip replacement is advised in patients with the following conditions:

• Worn out plastic or polyethylene prosthetic insert
• Dislocation of the hip
• Loosening of the femoral or acetabular component of the artificial hip joint
• Infection around the hip prosthesis 
• Weakening of bone around the hip replacement (Osteolysis)
• Fractures of the boned adjacent to the implants (falls)

Revision hip replacement surgery is performed under spinal anaesthesia and sedation. During the procedure, your surgeon will make an incision over the hip to expose the hip joint. Then the femur is dislocated from the acetabulum so that the old plastic liner and the metal socket can be removed from the acetabulum (hip socket).

After removal, the acetabulum is prepared. Sometimes bone-graft is needed to make up for deficiencies in the acetabular bone. Then the new metal shell is inserted into the socket using screws or a special cement. A liner made of plastic or ceramic is placed inside the metal socket (acetabular component).

The femoral component is then removed if necessary. Sometimes only a new head (ball) is needed, if the femoral component remains well fixed. The new femoral implant is inserted into the femur either by a press fit or using bone cement. Then the femoral head component, made of metal or ceramic, is placed onto the femoral stem. 

After undergoing revision hip replacement, you must take special care to ensure proper healing. Some of the common precautions (advised by the physiotherapist) to be taken for 6 weeks include:

• Avoid combined movement of bending your hip and turning your foot inwards 
• Keep a pillow between your legs while sleeping 
• Never cross your legs or bend your hips past a right angle (90 degrees)
• Avoid sitting on low chairs
• Avoid bending down to pick up things, instead use a grabber 
• Use an elevated toilet seat

Risks:

Although uncommon, as with any major surgical procedure, there are certain potential risks and complications involved with revision hip replacement surgery. The possible complications after revision hip replacement include:

• Infection
• Dislocation
• Fracture of the femur or pelvis
• Injury to nerves or blood vessels
• Formation of blood clots in the leg veins
• Leg length inequality
• Hip prosthesis may wear out
• Failure to relieve pain

Revision hip replacement removes your failed hip implants from a previous total hip replacement surgery, and replaces them with new ones. The aim is to help make your hip strong, stable and flexible again.