Revision Hip Replacement
Introduction
Total Hip Replacement (THR) procedure replaces all or part of the hip joint with an artificial device (prosthesis) with a plastic liner in between to restore joint movement
Why does a hip need to be revised?
Plastic (polyethylene) wear This is one of the easier revisions where only the plastic insert is changed
Dislocation (instability) means the hip is popping out of place.
Loosening of either the femoral or acetabular component. This usually presents as pain but may be asymptomatic. For this reason, you must have your joint followed up for life as there can be changes on X-ray that indicate that the hip should be revised despite having no symptoms.
Infection usually presents as pain but may present as an acute fever or a general feeling of unwell.
Osteolysis (bone loss) This can occur due to particles being released into the hip joint that result in bone being destroyed
Pain from hardware e.g.. cables or wires causing irritation
Pre-operation
Day of your surgery
Post-Operation Course
Post-operative X-rays will be performed in recovery.
Once you are stable and awake you will be taken back to the ward.
You will have one or two IV’s in your arm for fluid and pain relief. This will be explained to you by your anesthetist.
On the day following surgery, your drains will usually be removed and you will be allowed to sit out of bed or walk depending on your surgeon’s preference.
Pain is normal but if you are in a lot of pain, inform your nurse.
You will be able to put all your weight on your hip and your physical therapist will help you with the post-op hip exercises.
You will be discharged home or to a rehabilitation hospital approximately 5-7 days after surgery depending on your pain and help at home.
Sutures are usually dissolvable but if not are removed at about 10 days.
A post-operative visit will be arranged prior to your discharge.
You will be instructed to walk with crutches for two weeks following surgery and cane from then on until 6 weeks post-op.
Surgical Procedure
The surgery varies from a simple liner exchange to changing one or all of the components. Extra bone (cadaver bone) may need to be used to make up for any bone loss.
Special Precautions
AVOID THE COMBINED MOVEMENT OF BENDING YOUR HIP AND TURNING YOUR FOOT IN. This can cause DISLOCATION. Other precautions to avoid dislocation are
If you have increasing redness or swelling in the wound or temperatures over 100.5 degrees you should call your doctor.
If you are having any procedures such as dental work or any other surgery you should take antibiotics before and after to prevent infection in your new prosthesis. Consult your surgeon for details.
Your hip replacement may go off in a metal detector at the airport.
Risks and Complications
It is important that you are informed of these risks before the surgery takes place.
Complications can be Medical (general) or specific to the Hip
Medical Complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include:
Specific complications to the hip include
Failure to relieve pain
Discuss your concerns thoroughly with your Orthopedic Surgeon prior to surgery.