Surgical Information – Procedures

Revision Total Hip Replacement

What is revision total hip replacement?

Revision total hip replacement is a surgical procedure to remove the original prosthesis (implant) from a total hip replacement and replace it with a new one. Revision total hip replacement is a complex procedure that requires extensive pre-operative planning, specialized implants and tools, longer operating times and mastery of difficult surgical techniques to achieve a good result.

The goal of revision total hip replacement is to relieve pain and improve function in your hip. The most common reasons for the procedure include:

  • Failure of the original prosthesis due to loosening or significant wear and tear
  • Infection
  • Ligament instability
  • Excessive scar tissue around the hip joint
  • A fracture near the prosthesis (known as a periprosthetic fracture)
  • Dislocation
  • Metalosis

Some revision surgeries replace only part of the prosthesis. Others replace the entire device. In these cases, the surgeon must rebuild the bone around the hip with a bone graft. A specially designed implant, different from the type used in a standard total hip replacement, is required with longer, thicker stems that fit deeper inside the bone for extra support.

Anatomy

The hip joint lies between the femur and the pelvis, surrounded by protective muscle and cushioned by rubbery cartilage. It is the largest ball-and-socket joint in your body. The “ball” is the femoral head. The “socket” is a concave depression in the lower side of the pelvis called the acetabulum. Hip arthritis occurs when the cartilage of the hip joint gradually erodes. Without the cushioning effect of cartilage, the bones of the hip joint rub together. The hip can't move easily and becomes stiff, swollen and painful.

When is surgery recommended?

If you have had total hip replacement and develop hip pain that limits your everyday activities, you should consult an orthopedic surgeon trained in revision total hip replacement surgery techniques. After evaluating your condition, the physician may recommend a revision procedure.

What is the recovery time?

Recovery from revision total hip replacement is similar to that of total hip replacement, but may take a bit longer depending on the extent of the surgery and your overall health. Sometimes, your surgeon may recommend limiting the weight you put on the operative leg while the body grows onto the components or a fracture heals. Patients typically spend a night or two in the hospital and begin post-operative physical therapy to restore range of motion, flexibility and strength. Most people who have hip revision surgery report that it eliminates or diminishes pain and improves function. It commonly corrects leg length inequalities and can improve a patient’s ability to walk. Return to work and daily activities varies by patient and demand.