Revision Hip Replacement

What is Revision Hip Replacement?

During total hip replacement, the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. At times, hip replacement implants can fail, and may need to be revised (or redone) via a secondary surgery. Revision hip replacement is a complex procedure in which all (or part) of a previously implanted hip is replaced with new components.

Indications for Revision Hip Replacement

Revision hip replacement is advised for the following conditions:

• Worn out parts (typically plastic or polyethylene liner)
• Dislocation of previous implants
• Loosening of the implants
• Infection around the hip prosthesis
• Loss of bone around the hip replacement (osteolysis)

Procedure of Revision Hip Replacement

• During the procedure, your surgeon will make an incision over the hip to expose the joint.
• The femoral head (ball) is then dislocated from the acetabulum (socket), so that the old plastic liner and metal socket can be removed.
• If the femoral component is replaced, this is usually done prior to the socket exchange.
• After removal, the acetabulum is prepared, and the new metal shell is inserted into the socket.
• A liner made of plastic or metal is placed inside the metal socket.
• A new femoral head component made of metal or ceramic is placed on the femoral stem.
• All the new components are secured in place to form the new hip joint.

Post-procedure Care for Revision Hip Replacement

After undergoing revision hip replacement, you must take special care to prevent the new joint from dislocating and to ensure proper healing. Some of the common precautions to be taken include:

• Avoiding hip flexion past 90 degrees
• Limiting internal rotation of the hip
• Avoiding crossing your surgical leg
• Place a pillow between your legs while sleeping for 6 weeks
• Avoid bending down to pick up things; instead, a grabber can be used to do so
• Use an elevated toilet seat

Risks of Revision Hip Replacement

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
• Wearing of the hip prosthesis
• Failure to relieve pain

If you would like to have additional information on treatments of hip conditions or would like to learn more about revision hip replacement, please contact Joseph Mitchell, M.D., serving the communities of San Diego, La Jolla, East County, CA.