A revision hip replacement is the surgical procedure that involves the replacement or correction of a failed or problematic artificial hip joint. It is usually more challenging than a primary hip replacement because of factors such as adhesions, bone deficiency, and the necessity of removing the previous implant.

Revision Hip Replacement: Indications

Wear and Tear: The artificial hip joint may wear out over time, causing discomfort and less mobility.

Loosening: Loosening of the prosthesis from the bone may also occur which may lead to instability and pain.

Infection: Infection in the hip joint may require the removal and replacement of the prosthesis.

Dislocation: Recurrent dislocation of the hip joint may necessitate surgical intervention.

Fractures: Fracture in the vicinity of the artificial hip joint or in the bone supporting the prosthesis may require revision.

Bone Loss: Osteolysis, which is the bone loss that results from the body’s response to wear debris, may lead to the instability of the hip joint.

Mechanical Failure: Damage or failure of any of the prosthesis parts.

The Revision Procedure

Preoperative Assessment: This may include X-rays, CT scans, and MRI to determine the status of the hip joint and the adjacent bones.

Anesthesia: General or regional anaesthesia is given.

Incision: The surgeon then makes an incision over the hip to get to the joint.

Removal of Old Prosthesis: The current prosthesis is then carefully taken out. This can be difficult if it is firmly anchored to the bone.

Bone Preparation: If there is any damaged or infected bone, it is removed and the rest of the bone is reshaped for the new prosthesis.

Insertion of New Prosthesis: The new prosthesis is implanted. Bone grafts or other materials may be used to increase the amount of bone available for surgery.

Closure: The incision is closed and the patient is moved to the recovery room.

Recovery and Rehabilitation

Hospital Stay: Usually longer than primary hip replacement, sometimes taking several days.

Pain Management: Pain relief medications.

Physical Therapy: Passive mobilization and active range of motion exercises to regain function and muscle strength.

Weight-Bearing: This depends on the new implant stability and the condition of the bone.

Follow-Up: Out patient visits for follow up to check on the progress of healing and how well the new hip joint is working.

Risks and Complications

Infection: As with any surgery, there is always a risk, and this may be even greater in the case of a revision procedure.

Blood Clots: DVT or Pulmonary embolism.

Nerve Damage: Risk of nerve damage.

Dislocation: Greater risk than that of primary hip replacement surgery.

Leg Length Discrepancy: Compared lengths of the legs after the surgery.

Continued Pain: Some side effects may include: Persistent pain or discomfort in some cases.

Outcomes

Revision hip replacement surgery is more complicated and comes with higher risks compared to primary hip replacement; however, it can help patients with failed or problematic hip prostheses to experience improved function and quality of life. The outcome of the procedure is influenced by aspects like the need for revision, the general health of the patient, and the expertise of the surgical team.

Conclusion

Revision hip replacement is an important procedure for patients with issues related to their current hip prosthesis. Surgical methods and prosthetic options have evolved over the years and, therefore, the results and prosthesis lifespan have also been enhanced.