Revision Hip Replacement
What is a revision hip replacement?
Revision hip replacement is a 're-do' or 'second' artificial hip replacement, performed because of failure of the previous hip replacement procedure for any reason.
Why is revision required?
The most common reason for requiring revision of a hip replacement is gradual loosening of the grip between the bone and the prosthetic implants. This is a condition known as "Aseptic Loosening". Aseptic loosening usually occurs slowly over many years, with the artificial hip joint becoming increasingly painful over time. Typically the bone adjacent to the implant will have erosions due to the effect of wear debris. As hip replacement technology is constantly improving, with more durable bearing materials and better fixation methods, aseptic loosening is becoming less common and occurring much later stage after the original operation.
Other reasons for requiring a revision hip replacement include infection, dislocation or fracture of the bone surrounding the implants. Implant material failures such as metal stem or ceramic bearing fracture are exceedingly rare.
What does revision hip replacement involve?
Revision hip replacement procedures are very variable, as the nature of the operation depends on the problem causing failure of the original implant.
In general, revision hip replacements are technically more demanding than 'first time' replacements and are associated with an higher risk of complications and longer recovery times. Revision hip replacement often involves the removal of failed implant(s) and insertion of new prosthetic components. Not all implants necessarily require removal - some portions may be retained if the strength of bone contact is maintained and no wearing of the retained components is observed. In addition, as a result of the gradual loosening process over time, bone quality may be compromised and bone grafting may be required. Typically an artificial bone graft or donor bone is obtained for use in these situations.
For infection of a hip replacement, a 'two-stage' revision may be recommended. This is where the old implants are removed and the final implants are inserted in a second procedure only after the infection has been definitively erradicated.
As revision hip replacements are technically demanding, not all surgeons perform these procedures. In these situations, surgeons will often refer for ongoing care by colleague who performs these procedures on a more frequent basis. If you have been asked to see A/Prof Weinrauch for this reason, it does not indicate that your original surgeon is uninterested in your care - in fact quite the opposite !.
Before undertaking revision hip replacement, I will discuss the recommended procedure with you in detail.
Related publications
Scientific publications and research initiatives developed by the Brisbane Hip Clinic may be accessed via this link.
This information handout has been written by A/Prof Patrick Weinrauch for the purposes of patient education. The details provided are of general nature only and do not substitute for professional recommendations based an individual clinical assessment. © A/Prof Patrick Weinrauch. Brisbane Hip Clinic.
