Revision Hip Replacement

Dr Rodda and Dr Connon have a special interest in primary (Anterior Minimally Invasive Surgery), hip replacement, complex revision hip replacement surgery and hip fracture management. Dr Rodda and Dr Connon’s knowledge, experience and attention to detail and the time they invest with each patient during treatment and post-surgery, are the reasons many patients make Sunshine Coast Orthopaedic group their surgery of choice.

Revision Hip Replacement

Overview

There are several ways for a surgeon to perform total hip replacement surgery including (but not limited to): posterior (Moore), lateral (Hardinge or Liverpool), antero-lateral (Watson-Jones), minimally invasive and The Direct Anterior (Hueter) AMIS® approaches.

All hip replacements if performed correctly will result in a successful pain free outcome that should last at least 20-30 years using modern day implants. Today’s hip replacements do generally last a long time but there are a number of situations in which your hip replacement may need the implants to be changed or revised and another operation is required.

Depending on the reason for the revision, on the time that has lapsed since the first operation and the technique used in that surgery, revision procedures are often more complex that the initial operation and require careful planning and surgical skill.

Pain is the primary reason for a revision and although the cause can often be clear, it isn’t always.  Many hip replacement designs include a polyethylene liner inside the socket. This can wear and is one of the easier revision surgeries as only the plastic insert is replaced.

There is the possibility that your hip dislocates and revision surgery will be required if this is happening on too frequent a basis.  The most likely problems are:

  • An implant has been positioned incorrectly
  • There is a problem with the muscles, tendons or capsule around the hip
  • The hip has fractured after a fall or accident
  • There has been loosening of the femoral component. This usually presents as pain but may be asymptomatic.  For this reason it is essential that you maintain and attend your follow up appointments throughout your life, as your hip may need revision surgery despite having no symptoms
  • You may have an infection especially if you have a fever or generally feel unwell. Severe infections that do not respond to medical treatment require revision surgery
  • Osteolysis or bone loss can occur due to cement or polyethylene particles being released into the hip joint.  This is a less common problem with modern implants but it is still often seen on older implants
  • You are suffering pain from the implanted hardware such as cables or wires which cause irritation.

Process

Surgery is usually performed through the same incision however this may need some extension. Many surgeons utilise an extensile surgical approach such as a posterior or anterolateral approach for revision surgery.  The other option is to use an anterior approach.

This is because there is a reduced amount of bone to place the new total hip into. Extra bone may be required which is usually received from a bone bank. This allograft bone is totally safe and has been treated to eliminate any chance of disease transmission. There are also artificial bone substitutes that may be used. Revision total hip replacement generally takes longer than a standard total hip replacement and has a slightly higher complication rate. The prosthesis may also not last as long.

Benefits, Risks, and FAQs

The benefits and risks are generally the same as for regular hip replacement surgery however because this operation is usually a more complicated procedure it often does not produce as good results.  If you require revision surgery and have any concerns, please discuss these with Dr Rodda or Dr Connon.

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