Revision Hip Replacement Surgery
Expert Care for Addressing and Correcting Failed Hip Replacements
Revision hip replacement surgery, also known as revision hip arthroplasty or “redo” surgery, is a complex procedure aimed at addressing complications that may develop after your initial hip replacement.
The lifespan of a hip replacement varies and depends on factors such as your age, activity level, overall health, and the type of implants used.
Modern hip implants, made from durable materials like metal and ceramic, are designed to endure daily activities for many years and advances in surgical techniques, including minimally invasive approaches and precise implant positioning, have also contributed to longer-lasting outcomes.
If you’re experiencing persistent pain, instability, swelling, or decreased mobility however, these could be signs that a revision procedure may be necessary.
While these symptoms don’t always indicate the need for surgery, it’s important to consult with an experienced orthopaedic surgeon like Dr Keeley for a thorough evaluation and personalised guidance on the best course of action for you.
MAKING THE DECISION FOR REVISION HIP REPLACEMENT SURGERY
Making the decision to have revision hip replacement surgery is a complex process that requires careful consideration of various factors including:
The primary consideration for revision hip replacement surgery is the presence of symptoms and functional limitations that significantly affect your quality of life. These symptoms may include persistent hip pain, instability, stiffness, difficulty walking or performing daily activities, and decreased range of motion in the hip joint.
Diagnostic tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans play a crucial role in assessing the integrity of your existing hip replacement components, identifying any abnormalities or complications, and determining the extent of bone loss or damage around the implant.
Your overall health status, medical history, and comorbidities are important considerations in determining their candidacy for revision hip replacement surgery. Patients with underlying medical conditions such as cardiovascular disease, diabetes, obesity, or compromised immune function may face increased surgical risks and may require optimisation of their health before undergoing revision surgery.
Open communication between you and your healthcare team is essential for establishing realistic expectations and goals for revision hip replacement surgery. Patients should understand the potential benefits, risks, and limitations of the procedure and have clear expectations regarding post-operative recovery, rehabilitation, and long-term outcomes.
If diagnostic imaging reveals signs of implant wear, loosening, fracture, dislocation, or other complications, revision surgery may be necessary to address these issues and restore the function and stability of the hip joint.
Patients should be informed about the potential risks and complications associated with revision hip replacement surgery, including infection, blood clots, nerve injury, implant dislocation, fracture, and ongoing pain or stiffness. A thorough discussion of these risks allows you to make informed decisions about your treatment options.
Ultimately, the decision for revision hip replacement surgery should align with your preferences, values, and goals and patients should feel empowered to actively participate in the decision-making process and advocate for their needs and preferences throughout the treatment journey.
In cases where conservative treatment measures such as physiotherapy, medication, injections, and lifestyle modifications have failed to adequately alleviate symptoms or improve hip function, revision surgery may be considered as a viable option to address persistent issues and restore mobility.
TYPES OF IMPLANTS USED IN REVISION HIP REPLACEMENT SURGERY
In revision hip replacement surgery, specialised implants are essential to address challenges like bone loss, instability, and tissue damage. These implants are more robust than those used in your initial hip replacement, designed to manage complexities such as implant loosening, bone deficiencies, or infection, thereby providing greater stability and improving the chances of long-term success.
It’s important to understand that the durability of a revision hip replacement may be slightly less than that of your initial surgery due to the more complex nature of the procedure and the condition of the surrounding bone and tissues. Dr Keeley will carefully assess your situation and select the most suitable implant to ensure the best possible outcome for your revision surgery.
THE REVISION HIP REPLACEMENT SURGICAL PROCEDURE
Here’s an overview of what to expect during your revision hip replacement surgical procedure with Dr Keeley:
Before surgery, Dr Keeley will perform a comprehensive assessment of your current hip implant and overall health. This includes reviewing your medical history and conducting imaging studies like X-rays, CT scans, or MRIs. The goal is to identify the cause of the implant failure. Based on this evaluation, Dr Keeley will develop a customised surgical plan, selecting the appropriate techniques, choosing new implant components, and preparing for potential challenges such as bone loss, infection, or scar tissue.
On the day of surgery, you’ll meet with the anaesthetist to discuss your options, typically general anaesthesia or, in some cases, spinal anaesthesia. The surgical procedure begins with an incision, which may be made at or near the site of your original surgery. The location and length of the incision depend on the complexity of the revision and the issues that need to be addressed. Sometimes, the existing incision will be reopened, while in other cases, a new incision may be required.
The first major step is carefully removing the existing hip implant. This process requires precision, especially if there is significant bone growth around the implant or if it has become loose. Dr Keeley will use specialised tools and techniques to extract the implant without causing further damage. If significant bone loss has occurred, additional procedures like bone grafting may be necessary to rebuild areas of bone deficiency, ensuring a stable foundation for the new implant.
Once the old implant is removed and any necessary bone grafting is complete, Dr Keeley will prepare the hip joint for the new implant by reshaping the bone surfaces and ensuring the joint is clean and free of debris or infection. The new prosthetic components, such as a new acetabular cup, femoral stem, and bearing surface, are then precisely positioned. Dr Keeley will ensure the implant is securely fixed using either cemented or cementless techniques, with careful attention to alignment and positioning for optimal longevity and functionality.
After securing the new implant, Dr Keeley will carefully close the surgical site using layers of sutures or staples, followed by the application of a sterile dressing. In some cases, drains may be placed to prevent fluid buildup around the joint. Postoperative care begins immediately, with a focus on managing pain, preventing infection, and encouraging early mobilisation. Most patients typically stay in the hospital for 4 to 5 days following surgery to ensure a smooth recovery.
A structured rehabilitation program is crucial following revision hip replacement surgery. Physiotherapy will be tailored to your specific needs, focusing on restoring strength, flexibility, and function in your hip joint. Given the complexity of revision surgery, rehabilitation may be more intensive than after your initial hip replacement however, most patients can resume fairly normal activities within about 6 weeks. By approximately 6 months, many patients are able to walk without pain or a limp, marking significant progress in their recovery.