Hip Revision Surgery

Expert Guidance, How To Prepare, and Recovery Roadmap

Hip revision surgery, a complex and vital procedure in orthopedic surgery, aims to correct issues arising from previous hip replacement surgeries. Whether due to wear and tear, implant failure, or infection, this surgical intervention can restore mobility and quality of life. 

In this comprehensive guide, we delve into every aspect of hip revision surgery一from its necessity and preparation to the procedure itself, recovery, long-term outcomes, and more.

If you’re one of the many patients scheduled to undergo a hip revision procedure, head on below to know what to anticipate.

What is hip revision surgery?

Hip revision surgery or revision total hip arthroplasty is a surgical procedure performed to replace a previously implanted artificial hip joint with a new one. Its main goal is to address complications or deterioration from the original hip replacement surgery.

Unlike the primary hip replacement (which involves the initial creation of an artificial hip joint), hip revision surgery involves removing and replacing existing components to address issues that have arisen since the original procedure.

When is hip revision surgery necessary?

Hip revision surgery becomes necessary for various reasons, often stemming from complications following a primary hip replacement. Common triggers include:

1. Implant loosening

Over time, the components of the artificial hip joint may become loose or dislodged from the bone, causing pain, instability, and reduced mobility.

2. Implant wear and tear

The materials used in the artificial joint may wear down or degrade, leading to increased friction, discomfort, and potential damage to surrounding tissues.

3. Infection

Infection around the hip joint一either immediate post-surgery or later一can lead to pain, inflammation, and compromised joint function. Revision surgery may be required to address the infection and replace the infected components.

4. Fractures or breakages

Trauma or fractures near the hip joint, including fractures of the implant itself, may necessitate revision surgery to restore stability and function.

5. Implant failure

Components of the artificial hip joint may malfunction or fail prematurely, impacting the joint’s function and causing pain.

6. Limited mobility and persistent pain

If a patient experiences ongoing pain, limited range of motion, or dissatisfaction with the results of the initial hip replacement, revision surgery might be considered to address these issues.

How to prepare for hip revision surgery?

Preparing for hip revision surgery is crucial in ensuring a successful outcome. Proper evaluation, consultation, and preoperative assessments are significant in this process.

1. Evaluation and consultation with an orthopedic surgeon

Your surgeon will thoroughly evaluate your medical history, current symptoms, and imaging studies (such as X-rays and MRIs). 

They will then discuss whether hip revision surgery is the appropriate course of action, considering factors like your overall health, medical history, and the procedure’s potential benefits.

If revision surgery is recommended, the surgeon will outline a tailored treatment plan that aligns with your specific needs and circumstances.

2. Preoperative tests and assessments

Once hip revision surgery is deemed necessary, you’ll undergo a series of preoperative tests and assessments to ensure you’re physically prepared for the procedure. These may include:

• Blood tests
• Imaging studies
• Cardiac evaluation
• Medication review
• Infection screening

By completing these assessments, you and your medical team can work together to minimize potential risks and optimize your readiness for hip revision surgery.

3. Home preparations

Properly preparing your home environment before undergoing hip revision surgery is essential for a smooth and comfortable recovery. These steps can help ensure a safe and supportive place for your healing journey.

• Arrange a comfortable area for rest and sleep on the ground floor, if possible, to avoid stairs.
• Use supportive pillows, cushions, and a recliner chair to ease postoperative discomfort.
• Ensure necessary items, including medication, water, phone, and remote controls, are within easy reach.
• Install handrails along staircases and in bathrooms.
• Set up a bedside commode if needed, especially if bathroom access is challenging.
• Clear pathways to accommodate a walker or crutches.
• Organize necessities like clothing, toiletries, and snacks for easy access.

Furthermore, you should enlist the help of a family member, friend, or caregiver for the initial days or weeks post-surgery. Additionally, arrange for transportation to and from the hospital and follow-up appointments.

How is the procedure performed?

Hip revision surgery is a meticulous procedure that involves the removal of the existing artificial hip joint components and the replacement of new ones. 

Here’s a detailed step-by-step walkthrough of how the surgery is typically performed:

• You will be administered anesthesia, which may be general anesthesia or a combination of general and regional anesthesia.
• The surgeon makes an incision over the existing scar or slightly modifies it to access the hip joint.
• The surgeon dislocates the hip joint to gain access to the existing artificial components.
• The surgeon carefully removes the old components of the artificial hip joint, including the femoral stem and the acetabular cup.
• Any remaining cement or adhesive material is removed from the femur and acetabulum to prepare the bone surfaces for the new components.
• The surgeon places the new femoral stem into the femur and secures it using bone cement or a press-fit technique.
• The new acetabular cup is inserted into the hip socket, and bone cement or press-fit fixation is used, depending on the case.
• A new bearing surface, typically made of metal, ceramic, or polyethylene, is inserted into the acetabular cup to create a smooth articulation with the femoral stem.
• The surgeon assesses the stability and range of motion of the new hip joint, ensuring proper fit and alignment.
• After confirming the satisfactory positioning and function of the new components, the surgeon carefully closes the soft tissues, layer by layer.
• The incision is closed using sutures or staples, and a sterile dressing is applied.

What to expect during recovery and rehabilitation?

Restoring mobility and function after hip revision surgery involves a well-structured recovery and rehabilitation process. This phase is essential for achieving the best possible outcome and regaining your quality of life.

1. Immediate postoperative care

Following hip revision surgery, your immediate postoperative care is crucial for a smooth recovery. Here’s what you can expect:

• Monitoring and observation: You’ll be closely monitored as you wake up from anesthesia, with healthcare professionals tracking your vital signs and pain levels.
• Pain management: Adequate pain relief will be provided to ensure your comfort. Medications, nerve blocks, or epidural catheters may be used.
• Early mobilization: Depending on your surgeon’s recommendation, you may be encouraged to move your feet, ankles, and legs shortly after surgery to prevent blood clots and promote circulation.

2. Physical therapy and rehabilitation exercises

Physical therapy is a cornerstone of hip revision surgery recovery. A skilled physical therapist will guide you through exercises aimed at:

• Strengthening muscles: Exercises target muscles surrounding the hip joint to promote stability and support.
• Restoring range of motion: Gentle movements help improve flexibility and mobility in the hip joint.
• Walking and weight-bearing: Gradually progressing from assisted walking to full weight-bearing activities helps rebuild strength and coordination.

3. Gradual return to normal activities

The timeline for returning to your regular activities will vary based on individual factors, the complexity of your surgery, and your progress during rehabilitation. General guidelines include:

• Walking and mobility: You’ll start with assisted walking using crutches or a walker and gradually transition to walking unassisted.
• Driving: You may need to refrain from driving for a few weeks, depending on your comfort level, ability to move your hip, and adherence to pain medication.
• Return to work: Office jobs may allow a return within a few weeks, while physically demanding roles may require more time off.
• Exercise and sports: Engage in low-impact exercises like swimming or stationary biking as recommended by your physical therapist. High-impact activities may need more time.

Frequently asked questions about hip revision surgery

How long does the surgery take?

The duration of hip revision surgery typically ranges from 2 to 4 hours, depending on the complexity of the case and any unforeseen complications.

What are the long-term outcomes of hip revision surgery?

The long-term outcomes of hip revision surgery can vary, but many patients experience improved mobility, reduced pain, and enhanced quality of life.

Will I experience pain after surgery?

Pain is common initially, but pain management techniques, medications, and physical therapy help alleviate discomfort.

How long will the new hip last?

The longevity of the new hip joint depends on factors like age, activity level, implant type, and overall health.

Where to find the best outpatient orthopedic clinic for hip revision surgery?

At Raleigh Orthopaedic Surgery Center, your well-being and peace of mind are our top priorities. As one of the state’s premier surgery centers, we are dedicated to delivering exceptional care, advanced procedures, and comprehensive educational resources to empower you throughout your surgical journey.

Our board-certified Raleigh orthopedic surgeons and highly trained medical staff bring years of experience and a commitment to your health. Your comfort, confidence, and successful recovery are at the heart of everything we do. 

Contact us now to learn more.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.