What is a revision total hip replacement?

A revision total hip replacement is an operation to take out parts of your old hip replacement and put in new ones.

A hip replacement can fail for the following reasons.

• wearing out of the artificial ball-and-socket joint
• infection in your hip replacement
• dislocation (coming out of joint)
• fracture (break) of the femur around your hip replacement

What are the benefits of surgery?

You should get less pain and be able to walk more easily.

Are there any alternatives to surgery?

If your symptoms are mild, you and your surgeon may decide to watch and wait for a while.

If you have an infection in your hip replacement, using antibiotics over the long term can sometimes prevent your hip replacement from failing.

If your hip replacement keeps coming out of joint, you can wear a brace to try to keep your hip in place.

If you have a fracture near your hip replacement but the replacement is still well fixed to the bone, your surgeon may be able to fix the break with plates and screws without changing your hip replacement. If the break is small, it may heal without surgery if you rest your leg and use walking aids to get about.

What does the operation involve?

Various anaesthetic techniques are possible.

Your surgeon will make a cut on the side of your hip. They will remove your hip replacement and any cement.

Your surgeon will put in a new hip replacement, which is often larger than your old one. Your hip replacement is fixed into the bone using acrylic cement or special coatings on your hip replacement that bond directly to the bone.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• acute kidney injury
• venous thromboembolism
• difficulty passing urine
• chest infection
• heart attack
• stroke

Specific complications of this operation

• split in the femur
• damage to nerves around your hip
• damage to blood vessels around your hip
• infection in your hip
• loosening
• bone forming in muscles around your hip replacement
• dislocation of your hip replacement
• leg length difference
• death. The risk is less the fitter you are
• failure of the revision total hip replacement

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You can go home when your pain is under control, you can get about safely, and any care you may need has been arranged.

You will need to use walking aids until you can walk well without them. It often takes longer to recover from a revision hip replacement than your first hip replacement.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery and most revision total hip replacements work well.

A revision total hip replacement can fail with time, if it wears out, or the original problem comes back.

Summary

If your original hip replacement fails, you can usually have another operation to do your hip replacement again. If this revision operation is successful, you should be able to continue many of your normal activities.

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