Hip replacement revision surgery

What is a hip replacement revision surgery?

The hip is a 'ball and socket' joint that is susceptible to wear and tear which can be caused by injury or various bone diseases including osteoarthritis. This can often lead to severe pain and lack of mobility affecting your daily life, which will worsen over time. If medication cannot help, then the best option maybe an operation where your affected hip joint is replaced with an artificial one.

However, hip replacements do not last forever and so a further artificial hip may need to be implanted when the first one shows significant signs of wear and tear.

After the operation, you will be able to recover your previous levels of movement and walk better.

What does this involve?

Hip replacement revision surgery is done in hospital usually under general anaesthetic though regional anaesthetic can also be used. You would normally be admitted the evening before the operation and normal checks will be carried out. An injection to thin your blood will be given the same evening.

You will not be able to eat for eight hours prior to surgery although you will be able to drink small amounts of water up to four hours before.

Before the operation, your consultant anaesthetist will visit you to discuss which anaesthetic technique is best for you and, once the anaesthetic is administered, you will be fitted with a urinary catheter which will need to remain in place for a couple of days.

The operation itself takes between 60 and 90 minutes and your surgeon will make a small cut on the side of your hip and remove the damaged ball and socket. This will be replaced with an artificial joint which can be made of metal, plastic, ceramic or a combination of these materials, an acrylic cement is used to bond the new joint directly onto your bone.

Once the operation is over you would normally stay in the theatre recovery area for six hours where specially trained recovery nurses will monitor you.

When will I recover?

You are likely to stay in hospital for four to seven days after the operation and during this time we will get you mobile as soon as possible. We will assist you to stand on the same day if the operation is carried out in the morning, if not then early on the next day. You will be able to go home once you are comfortable, walking confidently and are able to go up and down stairs with the help of a walking stick or crutch.

Your physiotherapists will advise you on exercises in order to get you back to normal living and your nurses will provide you a discharge advice sheet.

You should see your own doctor's practice nurse about two weeks after the operation who can contact your consultant if there are any concerns - our physiotherapists will see you a further two weeks later. You will have an outpatient appointment with your consultant after six weeks once an X-ray of your hip has been taken.

In general, the first six weeks after surgery are about recovering from the operation - the next six weeks are about getting back to normal. Each patient is different of course and some people may recover quicker. There will be some restriction on driving and advice will be provided on when you can return to work.

What risks should I know about?

Hip replacement revision surgery is one of the most successful operations but there are some potential complications you should be aware of. These only affect less than 4 per cent of patients.

  • Infection can occur although we routinely prescribe antibiotics for the first 24 hours and our theatres have ultra-clean air operating conditions keeping infection rates at 1-2%.
  • Blood clots are possible in any major joint replacement surgery but again are in the 1-4% category and have well established treatments including aspirin.
  • Dislocation of the joint and leg length inequality are possible but the risk is less than 1%. This is kept to the absolute minimum through your consultant using the recommended posterior approach to the hip joint and excellent discharge advice from your physiotherapists and nurses with a home visit if needed.

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