What is hip revision surgery?

In hip replacement surgery, as performed at The Horder Centre, the diseased portions of the hipbones are cut away and replaced with a two-part prosthesis, or artificial hip joint.

With revision surgery, also performed at The Horder Centre, the original prosthesis is removed and replaced with a new one. Sometimes this is a long process involving more than one surgical procedure, and is certainly more taxing than the original replacement surgery.

The human hip is a ball and socket joint, in which the ball of one bone (the femur, or bone of the upper leg) fits into the socket of another (the pelvic bone). As a free-moving joint in the body, the normal hip can move backwards and forwards, from side-to-side, and can perform twisting motions.

Why do I need hip revision surgery?

Artificial joints do not last forever, and many show signs of loosening after a period of ten to 15 years. When an artificial joint is no longer securely attached to the bone, it is commonly because the bone absorbs next to the prosthesis and new abnormal motion occurs, resulting in pain on weight bearing. Revision surgery is an attempt to correct the problem in order to get the hip back to a condition where it can function normally.

Patients who have had an artificial joint implanted in their hip are usually people aged 55 or older who developed severe and debilitating arthritis in the hip joint. After a period of 10–15 years, the artificial joint may no longer fit securely. The pressure brought to bear on the hip, a major weight-bearing joint, eventually loosens the prosthesis and compromises its effectiveness.

Sometimes revision surgery is needed because infection has spread to surrounding tissue in the joint. When infected, the muscle, tendon, and ligament tissue in the joint can become damaged, losing elasticity and strength. Infection damages the bone, destroying bone stock that was present in the original surgery. If infection has developed in the hip joint, more than one revision surgery may be required. A first procedure may be needed to take out the old prosthesis scar tissue and then infuse the joint with antibiotics. At a later date, when the hip is cured of infection, surgery for a new prosthesis can be performed.

Pain relief is the most reliable potential benefit and often the major reason for hip revision surgery. For most people, a hip revision also offers better movement, strength, and coordination of the torso and leg. When a prosthesis is successfully replaced, the patient may experience another long period of time with relatively few problems in the hip.

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