Frequently asked questions (FAQs) about Revision Hip Replacement Surgery (THR Revision)

What is revision hip surgery or revision hip replacement and why is it needed?

Cemented hip replacements may fail after 10 to 15 years, or occasionally sooner due to loosening, wear or breaking of parts. A hip revision operation also known as revision hip arthroplasty is thus needed to replace the hip replacement that has worn out, loosened or has developed a problem.

How do I know when I need revision hip replacement?

If you have unrelieved pain in the hip that was replaced, your orthopedic surgeon can detect and determine whether you need a hip revision procedure using regular X-ray examinations. If a problem is detected, i.e. if the X-rays show damage has occurred to the hip replacement causing its failure, you may need to have a revision surgery before a major problem develops.

What are some of the situations that require hip revision surgery?

Component failure
The most common reason for hip implant failure is the wearing down of the plastic insert in the hip socket. In some other cases, the hip implant may shift slightly after surgery leading to unbalanced weight distribution and premature implant failure. Depending on the the kind of failure and the extent of the wear, only the plastic component or the entire implant together with the metal components will be replaced.

Osteolysis
The wearing down of the plastic component leaves tiny plastic particles in your body that are attacked by your body's immune system, and this immune response also attacks the healthy bone around your implant. This leads to a condition called osteolysis, in which the bone in the area around the joint implant softens as it is absorbed by the body, thus making your implant unstable and in need of revision.

Dislocation
Some patients do experience dislocation of the implant after surgery. In approximately half of these cases, your physician may be able to put your hip implant back in place without surgery. However, if your surgeon determines the implant was damaged, certain components of the ball-and-socket joint may need to be replaced in a revision procedure.

Fracture
If the bone next to your primary implant is fractured in an accident, revision surgery may be required in order to provide a safe, stable joint. In this case, the original implant may need to be removed, the fracture addressed and a revision joint implanted.

Infection
In a low percentage of cases, your hip may become infected after surgery. Although it may be successfully treated with antibiotics, there are severe cases where a follow-up revision surgery may be required.

Asceptic loosening
Aseptic loosening occurs when the hip implants become loose within the bone. A loose hip implant tends to be painful, and usually requires revision hip replacement. Reconstruction is possible through different methods including cemented or cementless components, with or without bone grafting, and the use of additional metalware such as screws, plates and cages to reinforce fixation.

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