What is Revision Hip Replacement?
Revision hip replacement is a surgical procedure performed when a previous hip replacement has worn out or failed. Unlike a first-time (primary) hip replacement, revision surgery involves removing an existing implant and replacing it with a new one. This procedure is often more complex because it requires careful removal of old components and secure placement of the new prosthesis, while also dealing with changes to the bone and surrounding tissue.
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Why Do Hip Replacements Wear Out?
Hip replacements can fail for a number of reasons. The most common cause is called aseptic loosening, where the implant gradually becomes loose within the bone. This usually leads to pain and loss of function, making revision surgery necessary.
Other reasons for failure include infection, fracture of the bone around the implant, or breakage of the prosthesis itself. Treatment depends on the cause. For example, in cases of infection, the implant may need to be removed, the infection treated, and a new implant inserted at a later stage.
Who is Revision Surgery For?
Revision hip replacement is considered for patients who experience pain, implant failure, or complications that limit their daily activities after an initial hip replacement. Because revision surgery is more technically demanding, it is carefully assessed and only recommended when the benefits outweigh the risks.
Benefits of Revision Hip Replacement
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Pain relief: Replaces a loose, damaged, or infected implant to significantly reduce discomfort.
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Stability and mobility: Restores joint function so patients can return to normal daily activities.
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Long-term joint health: Prevents further bone and tissue damage caused by a failing implant.
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Bone preservation: Maintains as much healthy bone as possible for future procedures.
Quality of life: With careful planning and modern techniques, many patients regain independence and improved function.
Why is Revision Surgery More Complex?
Revision surgery is more challenging than a primary hip replacement for several reasons. The quality of the remaining bone may be reduced, and removing the old implant often requires more extensive surgical techniques. The surgery itself typically takes longer, may involve more blood loss, and places greater strain on the patient, many of whom are older and may have additional medical conditions.
For these reasons, revision hip replacement requires detailed planning and coordination between the orthopaedic surgeon, anaesthetist, and other medical specialists to achieve the safest and best possible outcome.
Risks and Complications
As with any major surgery, revision hip replacement carries risks. Possible complications include:
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Infection, which may require antibiotics or further surgery.
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Blood loss and blood clots, though preventive measures are used to reduce these risks.
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Nerve injury, stiffness, or dislocation of the new implant.
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Loosening or failure of the new prosthesis over time.
Because revision surgery is more complex, these risks are higher than with a primary hip replacement. However, with careful planning and modern surgical techniques, outcomes are generally good, and many patients achieve significant pain relief and improved mobility.
Before and After Surgery
Before surgery, patients undergo a thorough medical assessment, including blood tests and imaging scans. It is important that any infections, including dental or urinary infections, are treated before the procedure. The surgeon will also review any other medical conditions to ensure patients are fit for surgery.
Recovery
After the operation, recovery may take longer than after a first-time hip replacement. Patients typically need walking aids such as crutches for several weeks, and rehabilitation with physiotherapy is essential to regain strength and movement. Swelling, stiffness, and discomfort are common in the early weeks but improve gradually over time. Regular follow-up appointments are arranged to monitor healing and ensure the new implant is functioning well.