Why would I need a revision hip replacement?

• There are many reasons that you may ultimately require a revision hip replacement. If you look at the “Painful Knee or Hip Replacement” page, the common different reasons are discussed one-by-one. Usually this surgery is required to help resolve ongoing pain, improve function, or stabilize an unstable replacement.

What makes a revision hip replacement different than an initial hip replacement?

• A revision hip replacement is more difficult than an initial hip replacement because many of the anatomic landmarks are changed or gone, there is more scar tissue, the bone may be damaged, and it is harder for the tissue to heal wounds. One of the major concerns is the damage to the bone around the implants, which can make getting a new implant stabilized in the bone more difficult, especially with regard to the pelvis (i.e. acetabulum). This often requires larger and more specialized implants. You may be limited in your ability to use the hip for a period of time after surgery while things begin to heal. Additionally, in order to fix the damaged joint, the surgery often requires a larger incision. There are many other unique factors that may be different based on why you require a revision surgery, and these will often be discussed on a patient-by-patient basis. Dr. Bradley will discuss your specific plan for surgery and recovery with you during your clinic visit.

How will my recovery be different?

• For the most part, we try to keep things as simple as possible and as similar to the recovery process as the initial hip replacement. Often the revision hip replacement will be performed using a posterolateral approach to the hip, as this allows Dr. Bradley to better address all issues that can arise. Because of this, you will often be asked to avoid certain movements (bending past 90 degrees, and/or flexing your hip and knee while pulling your knee towards your other leg), as part of this, we ask you to sleep with a pillow between your legs and generally limit activity during the initial healing. Additionally, depending on your surgery and situation, you may not be able to walk on your surgical leg for up to 6 weeks or longer, you may have a special dressing over your hip, and you may be taking antibiotics after your surgery for a 10-14 days.

Are there other things I should be worried about?

• While we take special care to try to limit risks of these surgeries for every patient, these revision surgeries have a higher risk of multiple complications. For revision hip replacements, we specifically worry that these revision surgeries have a higher risk of instability (hip dislocation) and infections. This often results from having multiple surgeries in the same area, from the injury or problem that led you to have the revision surgery, and from the larger, more specialized implants that we have to use, which can put more stress on your bone.