HIP REVISION SURGERY

Because revision hip replacement surgery is more complex than joint replacements our team of orthopaedic surgeons at Life Orthopaedic Hospital in Cape Town, South Africa, will conduct more detailed investigations prior to surgery. This investigation includes a discussion around the correct surgical technique, the necessity of a bone graft, and the way forward for the patient. In general, though, the most common reasons for revision surgery are:

• The hip joint is a "ball and socket" joint. Repetitive hip dislocation occurs when the ball joint (at the top of the thigh bone) goes out of alignment with the hip socket (hip bone). This may occur as a result of a hip fracture or multiple hip surgeries, or when the surrounding ligaments and muscles are not strong enough to hold the hip implants in place.
• Mechanical failure of the hip joint may occur as a result of general wear after total hip arthroplasty. If patients are very active, continual repetitive movement may cause small pieces of the prosthesis to break off. This can result in an immune response which could further damage the bones and artificial joints. Mechanical failure of the artificial joint may also be a result of trauma, such as a car accident or fall.
• Infection can occur at any time following surgery and is usually caused by bacteria entering the bloodstream. Depending on the severity of infection, interventions may range from surgical cleaning to a full prosthetic exchange, done in either one or two parts. Read more about infections in surgery.

Dislocation is more likely to occur following a revision surgery and loosening of the prosthetic may occur due to poor fixation in patients' compromised bone stock.  Bone fractures can occur either during or after surgery for the same reason. It may not be possible to fully correct leg lengths in complex cases. As with all surgical procedures, there is always a risk of infection. You can chat this through in greater detail with your orthopaedic surgeon, should you have any concerns.

As a candidate for revision hip replacement, you will undergo a very detailed analysis with our team of orthopaedic specialists before a diagnosis and surgical approach is decided upon. Some patients also find it helpful to go for physical therapy ahead of any surgery, as well as after.

For more details on what to expect and how to prepare for the surgery, as well as the weeks after surgery, read our article on the pathway to surgery.