Revision Hip Replacement

Joint replacements, like all other mechanical devices, wear out with time. Factors which influence the longevity of the prosthesis include activity level, weight, type of bearing surface and position of the implants. Typically the prosthesis will wear out gradually over time and changes occur on the x-rays before patients experience symptoms. The most common problems are referred to as linear wear of the plastic liner. In these cases, the plastic cup liner wears out and requires replacement. If caught early, the original cup and stem can be left in position and changing the plastic liner solves the problem. Loosening of the stem or cup of the replacement is more problematic and requires removal of the loose implant and re-implantation with revision prosthesis. These surgical procedures are typically fairly involved with surgical times of 3-5 hours and roughly 5 days in the hospital. Most patients will need to have a transfusion after surgery and I have most patients on low-molecular weight heparin for 3 weeks after surgery to reduce the risks of blood clots. I keep patients undergoing revision surgery on protected weight bearing to ensure the prosthesis has good in-growth into the bone. Total recovery often takes 3-6 months depending on the type of revision surgery. Risks after surgery are similar to primary total hip arthroplasty, however the risk of dislocation is significantly higher that primary total hip replacement. The reason is revision surgeries require larger surgical exposures and soft tissue releases to allow the surgery.