Introduction
	Why Does A Hip Need To Be Revised?
	Investigations
	Surgery
	Post-Operative

INTRODUCTION

This means that part or all of your previous hip replacement needs to be redone. This operation varies from very minor adjustments to massive operations replacing significant amounts of bone and hence is difficult to describe in full.

A Hip Replacement consists of a femoral component with a ball placed onto it, an acetabular component attached to the pelvis, and an insert in between.

WHY DOES A HIP NEED TO BE REVISED?

• Pain is the primary reason for revision. Usually the cause is clear but not always. Those hips without an obvious cause for pain in general do not do as well after surgery.
  
  
• Plastic (polyethylene) wear .This is one of the less complicated revisions where only the plastic insert is changed.
  
  
• Dislocation (instability) which means the hip is popping out of joint.
  
  
• Loosening of either the femoral or acetabular component. This usually presents as pain but may be asymptomatic. It is for this reason that you must have your joint followed up for life. There there can be changes on X-ray that indicate that the hip should be revised despite having no symptoms.
  
  
• Infection - usually presents as pain but may present as an acute fever or a general feeling of being unwell.
  
  
• Osteolysis (bone loss). This can occur due to particles being released into the hip joint which result in bone being destroyed.
  
  
• Pain from hardware e.g., cables or wires causing irritation.

INVESTIGATIONS

• Xrays are essential and should be of good quality.
  
  
• A CT scan may be ordered to look closer at the anatomy.
  
  
• Routine blood tests - especially to rule out infection.
  
  
• Bone scans can help to determine if a component is loose.
  
  
• Aspiration of the joint is occasionally done to diagnose or rule out infection.

SURGERY

It will be explained to you prior to surgery what is likely to be done but in revision surgery the unexpected can happen and good planning can prevent most potential problems. The surgery is often, but not always, more extensive than your previous surgery and the complications similar but more frequent than the first operation. (see complications section in Total Hip Replacement).

The surgery varies from a simple liner exchange to changing one or all of the components. Extra bone (cadaver bone) may need to be used to make up for any bone loss.


POST-OPERATIVE

Again this is similar but often a bit slower than the first hip replacement. The amount of weight you can put on it and the recovery period really does depends on what was done and is hard to generalise.