Revision Hip Surgery
What Is Hip Revision Surgery?
Hip revision surgery is designed to replace a failed implant that could have failed for many different reasons. These reasons include loosening, dislocation, wear and tear of the implant or bearing surface, infection, and fractures or breaks around the implant.
Revision surgery aims to find an answer to problems that arise when the implant isn’t working or performing as well as you’d expect it to.
Why Might I Need a Revision?
Common reasons for revising a hip are dislocation infection, wear and loosening. When an implant has been in place for a very long period of time and has worn away, resulting in pain either in the thigh or groin. If you’re experiencing these symptoms, it raises alarm bells and means I would need to assess and examine you further.
Book my appointment
If you’re ready to take the next step, I’d be happy to help. You can book an appointment by calling my team directly or using the online booking form. Whether you’re insured or self-funding, we’ll guide you through the process clearly and simply.
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How Do I Know Something Is Wrong?
It can be very difficult to know if there’s something serious going on unless something major happens – like a dislocation – which immediately indicates something has gone wrong and would be an indication to change your hip, particularly if it dislocates early.
Otherwise, you might notice something is wrong if you still have pain in your groin or the same symptoms you had before your hip replacement. Sometimes the hip socket could be too big and impinging on the tendon in the front of your hip. These are all reasons to get assessed.
Checking for Infection
To determine whether there’s infection in your hip, I would need to take your history and assess you clinically. I’d look for any problems with your wound healing and examine your wound to ensure there are no signs of infection and that everything has healed properly.
If pain has suddenly come on, I can check for infection by doing an aspiration – taking a sample from your hip and sending it to the lab to see if anything is growing. I’d also arrange blood tests. This information gives me clarity about whether there’s a risk of infection in your hip.
Can Infection Occur Long After Surgery?
It’s always a possibility that infection can stay quite silent and something may precipitate it to become florid. If your hip has been performing well, that risk is low. However, if something has suddenly changed, that would increase the risk of infection. During every revision case, I always take samples to rule out infection as a secondary cause.
What Happens If I Have an Infection?
If you have an infection in your hip and you’re in pain, we’ll discuss the different options available. Your hip replacement will need to be changed – otherwise, the infection is likely to get worse.
This usually means at least two operations, depending on the cause of the infection and the bug. If the bug is well known and the infection is caught early enough, I can discuss the possibility of a single operation, but this carries a higher risk of not completely clearing the infection.
The Two-Stage Revision Process
If you have a serious infection, we first need to identify the bug through thorough assessment. We’ll then sit down and discuss revision surgery.
The first stage involves removing the infected implants and putting in temporary implants that function as spacers. These help clear the infection along with antibiotics, preparing for the next stage.
The second stage is usually done three to six months after the first, depending on how successfully we’ve managed to clear the infection.
Living with a Spacer
You are mobile when you have a spacer in your hip. The downside is that you’ll be given hip precautions so the spacer can bed in properly and the muscles in the back of your hip can heal from such a major operation.
How Invasive Is Revision Surgery?
It depends on the reason for revision and which parts of your hip are being changed. If just one part is being changed (such as the hip socket for dislocation), it’s not as traumatic as if both sides are being changed.
In general, recovery takes almost twice as long as from a primary operation. If you’re having a procedure for infection, it can take even longer to recover – it’s one of the hardest things to recover from.
Why Choose Me for Your Revision?
I specialise in revision hip surgery – very few surgeons in Dorset do so. All cases are discussed at a regional MDT meeting with other hip surgeons and colleagues.
Having done many revision procedures and being fellowship-trained in revision surgery, I have the specialist expertise to ensure you get the best possible outcomes from such complex surgery.