What is revision hip replacement surgery?
Revision hip replacement surgery refers to procedures which are undertaken to address the biological or mechanical failure of a total hip replacement. These ‘reoperations’ are designed to address the cause and consequences of a failure.
The younger a total hip replacement patient is, the more chance there is that they will need revision hip replacement surgery at some point.
What can I expect from the procedure?
Prior to the procedure, you will discuss the operation with Mr Mann, giving you the opportunity to raise any questions or concerns you may have. You will also discuss the best method of anaesthesia with your anaesthetist, which will be recommended based on your personal circumstances and medical history.
Your surgeon in some cases will consult imaging to determine the replacement part’s exact location, and several different parts might be reoriented, or swapped entirely, in the process of the revision.
Some revision hip replacement surgeries use a constrained socket which is able to ‘capture’ the ball of the hip. Extra bone is sometimes required, as well as artificial bone substitutes which the surgeon may use. The extra bone is to make up the shortfall which is often present.
In general, revision hip replacement is a longer, more complex operation that a total hip replacement and the prosthesis put in place might last for a shorter period than a primary hip replacement.
Why might I need revision hip replacement surgery?
Revision hip replacement surgery is relatively rare and is commonly needed to address the wear and tear of implants, and their loosening or breaking.
Other reasons for revision hip replacement surgery include a repetitive dislocation of a hip replacement, to prevent further dislocations, and its infection. Elderly patients, in particular, are predisposed to the complication of dislocation, as well as those who have had a hip replacement following multiple surgeries.
What is the recovery time?
Typically, it is possible to resume normal activities within six weeks of revision hip replacement surgery. Your surgeon will be able to recommend a series of exercises designed to strengthen the hip muscles, as well as advice on positions in which to keep the leg to help avoid hip dislocation.
A walking frame may be needed immediately after the operation; scaled down to crutches or a walking stick in the days following. It is recommended that patients mobilise as soon as they can, so as to prevent complications such as chest infections or deep vein thrombosis.
Mr Mann will ensure that when the time comes for you to go home, that you have all of the advice and information that you need to make a fast and full recovery.
For information about how we might be able to help you or if you just have a question, please get in touch with us using the contact form below.
Postoperative period and recovery
Remember that below is a guide to recovery and that everyone heals at different rates and some people do take longer. Use this information to help you understand your condition, possible treatment and recovery. The timeframes given below are a minimum, it is important that you appreciate this when considering surgery as your healing and recovery may take longer.
After your operation, a routine enhanced programme of recovery will commence. The main parallel work streams of this programme are as follows:
Mobilisation is commenced on Day One. Gradually there is an increase in the frequency of transfers in and out of bed. This then progresses onto stairs and mobilisation to the toilet/shower and back. Before discharge, the patient is well rehearsed in the exercise routine and the knee should bend to at least ninety degrees. It is extremely important to remain well motivated and perform your exercises after discharge to fully optimise the range of motion of the newly replaced knee.
Will focus more on activities of daily living, functional transfers and adaptation of the home environment.
During the operation, spinal anaesthesia with local infiltration of anaesthetic around the hip is used. After the operation regular oral medication is then used. Ask for extra if required. Before discharge required prescriptions are provided.
It is perfectly ok to experience an ooze from the wound especially as one mobilises. Your dressing may require changing. Before discharge, the wound should be dry and arrangements will be in place for staple removal by your practice nurse.
Immediately after the operation intravenous (directly into the veins) fluids are given. Medications such as routine antibiotics are also given via this route. Urine output is carefully monitored. A bedside commode may be needed during the first postoperative day.
Normal diet is introduced as soon as possible. The urine catheter is removed once mobile. Bowel habit should also return to normal before discharge.
On the first morning after the operation ablutions are performed at the bedside. Showering is then gradually introduced – at first with assistance and then independently.
Problematic total hip replacement
The problematic total hip replacement is one which continues to be painful or is unstable. Sometimes other issues such as a leg length inequality may be causing a problem.