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Understanding hip revision surgery

Hip replacement surgery is one of the most successful operations in modern medicine and has helped to restore movement to millions of people across the world. However, hip replacements will eventually wear out over time, just like a normal joint.

When this happens, hip revision surgery will be needed in order to restore function to your hip and to help you remain as active and mobile as possible.

What is hip revision surgery?

Hip revision surgery is a surgical procedure to replace an artificial hip prosthesis that has worn out or ‘failed’.

The prostheses used for artificial hip replacements are usually expected to easily last for 10+ years, although they can be affected/damaged by trauma, infection and age.

This may lead to the need for a further operation, known as hip revision surgery.

Your original hip replacement surgery would have been carried out because the normal function of your hip was significantly altered or impaired through disease or trauma.

The surgery involved replacing the natural hip joint with an artificial joint (sometimes referred to as a prosthetic joint) in order to restore function and mobility and to remove any pain that you were experiencing in your hip joint.

Should your original hip replacement now not be working as well as previously, your hip doctor (usually a consultant orthopaedic surgeon) may recommend that you have another operation to remove all or parts of your original prosthesis and to replace them with a newer prosthesis.

The aim of this ‘revision’ surgery is to remove any pain while restoring mobility and function in your hip joint as much as possible.

Hip revision surgery is usually a longer, more involved operation than the original hip replacement surgery. The exact surgery carried out will be determined by your current prosthesis; if only some parts of it have failed, they can sometimes be replaced without the need to remove and replace the entire prosthesis. In other situations, the entire prosthesis will need to be expertly removed and replaced.

Your original hip replacement would have been fixed in place securely, but over time it can sometime work a bit loose. Sometimes, the bones and/or soft tissues around the hip joint may be damaged and this can alter the stability of the prosthesis.

Hip revision surgery often requires the use of specialised implants (prostheses), as the ‘standard’ ones used in normal hip replacement surgery are often not able to be used. 

For the surgery, you will be given a general anaesthetic, meaning you will not be conscious during the operation. Your surgeon will make a precise cut to give them access to the hip joint. They will expertly assess the current state of your hip replacement and the soft tissues surrounding it, to ensure they are able to remove the failed prosthesis in the best way possible. If your original prosthesis was fixed in place with a special cement, this will also be carefully removed at this time.

Once the original prosthesis has been successfully removed, your surgeon will insert the new one into the optimal position, often using a series of surgical screws to help hold it in place. The joint will then be tested for its range of motion and stability before the surgeon stitches up any incisions and places a wound dressing over your hip. You may also have a small tube placed in your hip following surgery. This is known as a ‘drain’, as its function is to drain any excess fluid and/or blood from the site of the surgery.

Following your surgery, you will be taken to the recovery room, where out theatre staff will monitor you carefully while you wake up from the anaesthetic. 

Hip revision surgery is a major procedure and it is important not to underestimate the length of time it may take you to fully recover.

You will usually need to spend a couple of days in hospital after your surgery, where you will supported by our Hip Clinic specialists, including nurses, physiotherapists and occupational therapists, to ensure you are able to return home safely as soon as possible.     

Like all surgical procedures, hip revision surgery carries risks and the potential for complications. These include:

  • Infection in the hip joint,
  • Dislocation of the hip joint,
  • Bleeding inside the hip joint,
  • Damage to the nerves near the hip joint,
  • Formation of a blood clot (known as a ‘deep vein thrombosis’ or ‘DVT’).

The above risks are intended as guidelines only and are not exhaustive.

We always recommend that you talk with your consultant about potential risks and complications before you decide to have any surgery.

The consultant-led orthopaedic Hip Clinic at St Joseph’s has vast experience in carrying out hip revision surgery.

Should you have previously undergone hip replacement surgery and are now experiencing pain or stiffness in your hip joint, please contact us to arrange a consultation with one of our hip specialists who will be able to give you expert guidance on the best treatment options available for you.