Home > Condition & Treatment Map > Hip & Pelvis Conditions & Treatments > Revision Hip Replacement

Overview

Surgeons at Victorian Bone and Joint are fellowship trained in hip replacement and revision hip replacement surgery. They regularly assess patients in Melbourne for hip conditions and can recommend hip surgery when required. Revision hip replacement surgery is a special interest for surgeons at Victorian Bone and Joint Specialists.

If you have a problematic hip replacement it may require revision surgery (surgery to replace parts of the artificial hip). For this surgery to be successful a cause for the original hip replacement problem must be found.

Surgeons at Bone and Joint will look at x-rays and scans of your hip replacement to determine the position and look for any signs of loosening. CT scans are sometimes used to assess the alignment and size of the hip replacement to see if this is causing any issues. Bone scans may be organised to check for infection or loosening of your hip replacement.

If no cause for your problematic hip replacement can be found, surgery is unlikely to be successful and may not be offered. When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, are other options can be considered.

If surgery is required to revise the hip replacement then specialist planning imaging (CT scans and X-rays) will be organised. Surgery to remove the old hip replacement and place in a new hip replacement will be performed. The results of this type of surgery are typically good.

Unfortunately, patients with total hip replacements suffer trauma from falls or accidents, and this can make the hip replacement unstable which requires revision surgery. Anyone who has a hip replacement and sustains a significant fall should have an x ray and be reviewed by an Orthopaedic specialist.

What to Expect After Surgery

Revision hip replacement surgery depends upon the underlying diagnosis, which your surgeon will talk you through prior to discussing surgical treatment. Surgical treatment can involve either exchange of one, or multiple of the components depending upon where the problem lies. Sometimes, problems are only found after surgical inspection of the artificial hip joint. Revision Hip Surgery is generally major surgery and a significant amount of planning is required.

Given the variability in revision surgery, you should expect to spend several days or even a week in hospital. While you may be able to get out of bed or walk the day after surgery, you will be walking with crutches or a walker for a period post-surgery. Some discomfort is normal after surgery and is managed in conjunction with our Anaesthetics team.

Hip Revision surgery can be very effective and have excellent long-term results, however, given the complexities with the surgery revision hip replacements are slightly less successful than the original hip replacement.

Post Operative Care

A dressing will be placed over the hip following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed. Sometimes a drain to collect excess fluid will be placed into your hip at the time of surgery – this is normally removed after 2 days. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots. Special vacuum dressings can help seal the wound as it heals.

Discharge home: After your surgery you will stay in hospital for several days, maybe even a week. You will be discharged home with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.

Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.

Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.

Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery. It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.

Wound review: After 2 weeks you will have an appointment with your orthopaedic surgeon to have your wound checked, any stitches will be removed. Your orthopaedic surgeon will then give you advice on exercises and physiotherapy.

Driving: You cannot drive until you have had your first review appointment with your surgeon. They will give you an indication then when you are likely to be able to drive again

Returning to work: This depends on the type of work you do. Most surgeries will need 6 weeks off work, some will require longer, especially if you have a manual job.

A revision hip replacement operation is major surgery. Despite good results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Your surgeon will discuss with you the risks of surgery.

Risks

As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or specific to the hip.

Medical Complications include those of the anaesthetics and your general well-being. Complications include:

Allergic reactions to medications
Blood loss requiring transfusion
Heart attacks, strokes, kidney failure, pneumonia, bladder infections
Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation, or rarely death

Specific complications of hip revision include:

Infection: Infection can occur with any operation. If it occurs, it can be treated with antibiotics, but may require further surgery. Very rarely, your hip may need to be removed to clear the infection.
Blood clots (deep venous thrombosis): These can form in the calf muscles and travel to the lung (pulmonary embolism). These can occasionally be serious and even life-threatening. If you get calf pain or shortness of breath at any stage, you should notify Dr Slattery immediately.
Dislocation: This occurs when the ball of the replacement slips out of the socket. This occurs more commonly after revision hip replacement than your first hip replacement. If it occurs it need to be put back into socket, and if it occurs multiple times it may require an operation.
Fractures of the femur (thighbone) or pelvis (hip bone): This is also rare but can occur during or after surgery. This may prolong your recovery or require further surgery.
Damage to nerves or blood vessels: These are very rare but can lead to weakness and loss of sensation in part of the leg. Damage to blood vessels may require further surgery if bleeding is ongoing.
Wound irritation: Your scar can be sensitive or have a surrounding area of numbness. This normally decreases over time and does not lead to any problems with your new joint.
Leg length inequality: It is very difficult to make the leg exactly the same length as the other one. Occasionally, the leg is deliberately lengthened to make the hip stable during surgery. There are some occasions when it is simply not possible to match the leg lengths. All leg length inequalities can be treated by a simple shoe raise on the shorter side.
Failure to relieve pain: this is very rare, but occasionally pain felt in the hip can be coming from the back.
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FAQs

When can I walk after hip revision surgery?

Weight-bearing and walking is allowed immediately after surgery. Initially, this will be aided by crutches.

When can I drive after hip revision surgery?

Your ability to drive will depend on the side you had your operation, left or right, and the type of vehicle you drive, manual or automatic. It is reasonable to drive when you are confident with walking and can fully weight-bear on your affected side. The usual recommendation is 6 weeks.

When can I work after hip revision surgery?

Your return to work will vary depending on the procedure performed and type of work you are engaged in. Most people can return to office work within 4 weeks.

When can I do exercise after hip revision surgery?

Low impact activities, such as cycling and hydrotherapy, can be commenced from week 2 when the wound has been checked and you have been reviewed.

How long will I take to heal?

The wounds take 7-10 days to heal. They should be kept clean and dry during this period

Revision Hip Replacement