Hip Revision Surgery

What is hip revision surgery?

Hip revision surgery is a procedure that repairs or replaces an artificial hip joint. You may need this procedure after hip replacement surgery to correct any damage to your artificial hip that happened because of:

• Normal wear and tear.
• Loosening of the implant from the bone.
• Dislocation (“popping out”).
• An infection.
• A broken bone around the prosthetic (artificial hip joint).
• Alignment issues.

Damage to your artificial hip joint can cause symptoms of pain and discomfort. You might not be able to use your hip to its full potential. The goal of hip revision surgery is to improve the function of your hip.

Why do I need hip revision surgery?

You may wonder why you need additional surgery after hip replacement surgery. Human-made (artificial) implants, or prosthesis, that your orthopaedic surgeon used to replace your hip during your first surgery doesn’t last forever. The typical life of an artificial hip joint is 10 to 20 years, depending on the daily use of your joint.

Think of your artificial hip implant as a vehicle. Over time, your car will need maintenance to keep it running. Your car is susceptible to normal wear and tear from frequent use. You may need to repair or replace your vehicle with a newer model that will get you back on the road. Hip revision surgery is the maintenance or repair that your artificial hip joint needs to keep functioning as expected.

What does hip revision surgery treat or manage?

After hip replacement surgery, normal, day-to-day movements wear down your artificial joint. This can cause your prosthetic to be loose, dislocate or not fit securely, which can keep it from functioning as it should. You’ll likely feel pain around your artificial hip. This is a sign that you might need this procedure. After revision surgery, your pain should lessen or go away and you’ll regain function of your artificial hip.

Infection is another reason why you may need hip revision surgery. An infection around your artificial hip joint can cause pain and weaken and damage your muscle, tendon and ligaments, along with your hip bone. To prevent this damage, your healthcare provider may recommend hip revision surgery.

How common is hip revision surgery?

Hip revision surgery isn’t common but may be necessary if you have an infection or damage to your artificial joint.

How should I prepare for hip revision surgery?

About a month before your hip revision surgery, you’ll meet with your care team to discuss your surgery and possible risks. They’ll also perform a physical exam, take a complete medical history and review any medications or supplements you currently take. Tests are also necessary and could include:

• Lab testing.
• Urine analysis.
• Electrocardiogram (EKG).
• X-rays.

When you schedule your hip revision surgery, you’ll also schedule appointments to meet with a physical therapist after your procedure. To prepare you for your surgery, your surgeon will go over specific instructions, like what medications are safe to take and what you should stop taking before the procedure. Don’t stop taking any medications unless your provider tells you it’s safe to do so.

Preparing for hip revision surgery at home

You can take steps at home to help you prepare for an easier recovery after hip revision surgery by:

• Asking someone to help you out at home for the first few weeks after surgery.
• Trying to stop or cut down on smoking before your surgery, if you smoke.
• Removing tripping hazards — like loose rugs or electrical cords — from your home.
• Moving commonly used household items, foods and beverages to a shelf or counter at your waist or shoulder level.
• Organizing your sleeping area on the main floor to avoid going up and down stairs.
• Using special equipment around your home to help you complete your daily tasks. You can use an elevated toilet or shower seat or a grasping device to help you put on your socks and shoes.

Dental preparations for hip revision surgery

Before hip revision surgery, your surgeon may recommend visiting a dentist to get a teeth cleaning and to take care of any cavities. You’re more at risk of developing an infection after your surgery because germs can enter your bloodstream via your mouth. Your hip needs extra blood supply while you heal, which makes you more susceptible to infection. After your surgery, your surgeon may recommend you wait three months before you visit the dentist unless you have a dental emergency. After your surgery, you’ll need to take antibiotics before you get any dental work done to prevent infections.

What happens during hip revision surgery?

During hip revision surgery, your surgeon will remove all or part of your artificial hip joint and replace it with a new one.

In more severe infection cases, hip revision surgery happens in two different surgeries. The first surgery removes the artificial joint and treats the infection with antibiotics. Once the infection clears, the surgeon will perform a second surgery to place a new hip joint.

How long does hip revision surgery take?

Hip revision surgery can take about two hours. Your surgeon will give you an approximate time estimate before your procedure.

What can I expect after hip revision surgery?

After hip revision surgery, you’ll need to stay in the hospital for a few days so your care team can monitor your healing progress. When you leave the hospital, you’ll complete your recovery at home. Your surgeon will give you care instructions that could include:

• Taking medications as directed to relieve pain and reduce your chance of getting a blood clot.
• Attending follow-up appointments and physical therapy on schedule.
• Keeping both legs elevated with a pillow or on a reclining chair for the first four to six weeks following surgery.
• Using equipment to help you walk, like a walker or cane, until you’re able to put full weight on your hip.
• Using handrails when going up or down stairs. Avoid using stairs immediately after surgery.

What are the benefits of hip revision surgery?

Hip revision surgery is a voluntary but safe procedure. The benefits of hip revision surgery include:

• Relieving pain.
• Improving mobility, strength and coordination of your torso and leg.
• Allowing you to return to your normal activities.

How successful is hip revision surgery?

The majority of hip revision surgeries successfully reduce pain and improve your range of motion. To increase the success of hip revision surgery, you’ll need to complete rehabilitation and physical therapy during your recovery as directed.

What are the risks or complications of hip revision surgery?

Every surgical procedure comes with potential risks. The possible complications of hip revision surgery could include:

• Lung or heart complications from anesthesia.
• Infection.
• Blood clots.
• Scarring.
• Injury to nerves or blood vessels.
• Weakness or instability of the joint.
• A need for additional revision surgeries in the future.

Your surgeon will explain the possible risks of your surgery before your procedure.

What is the recovery time for hip revision surgery?

The recovery time for hip revision surgery is approximately six months. There’s an adjusting period after surgery because normal activities like getting into a car and climbing stairs are going to be difficult. You’ll have a limp when walking and some pain that should go away after six months when you’re completely healed.

After surgery, you can improve your recovery time by:

• Exercising your legs to reduce swelling as directed.
• Elevating your legs above your heart when resting by placing your feet on a pillow.
• Using a walker after surgery. When you’re comfortable, following your doctor’s instructions, you can switch to a cane.

After approximately a month, your healthcare provider will take X-rays of your leg to monitor healing. If you have severe pain or swelling after surgery, contact your provider.

Do I need physical therapy after hip revision surgery?

Yes, immediately after surgery, you’ll start rehabilitation and physical therapy. Your physical therapist will monitor the strength and flexibility in your leg and hip, as well as your ability to stand and sit.

Physical therapy will continue while you’re in the hospital and when you go home. You’ll need to keep doing physical therapy for about a year. Your physical therapist will give you instructions so you can continue exercising at home, outside of your appointments. They’ll also explain what exercises and activities are safe to do following your surgery and when you can get back to your normal routine.

When should I call my healthcare provider?

Contact your provider if you notice any of the following symptoms after hip revision surgery:

• Increasing redness or color changes to your skin near your surgical site.
• Severe pain or swelling.
• Drainage at the incision.
• Bumps or pimples.
• Calf pain, coughing, chest pain, trouble breathing.
• Any other changes that concern you.

How frequently should I schedule follow-up appointments with my doctor after hip revision surgery?

You’ll need to schedule follow-up appointments after your surgery so your surgeon can monitor how well your hip is healing. After your surgery, you may need to schedule appointments during the following times:

• Four to six weeks.
• Three to six months.
• One year.
• Annually, on the anniversary date of your surgery.

You’ll need hip X-rays at most or all of your appointments.

A note from Cleveland Clinic

If you’re in pain or unable to use your artificial hip as you used to, you may be a candidate for hip revision surgery. It can be an emotional process going into surgery for a second time. Your surgeon is available to answer any questions and put you at ease before your procedure. Make sure you attend follow-up appointments with your care team to see that your new hip is healing properly and you no longer have pain or discomfort. Physical therapy and strengthening exercises will help you gain greater mobility and ensure an easier recovery following hip replacement.