The Wellington Hospital
Wellington Place St John's Wood NW8 9LE London
Hip revision surgery
If severe pain, stiffness or swelling in your prosthetic hip is causing you pain and discomfort, hip revision surgery can improve your mobility again.
Book an appointment with one of our orthopaedic hip specialists today.
- Consultant appointments confirmed immediately or at the latest the next working day
- Medical imaging can be arranged for the same day as your consultant appointment for convenience, if required
- Access to leading hip specialists, placed within the top 1% for revision rates in hip replacement when compared to the National Joint Registry (NJR)
- Experts in revision surgery for those that require their hip joint replaced again
What is hip revision surgery?
Hip revision surgery is an operation (known as arthroplasty) to renew a prosthetic hip joint. While modern hip replacements usually provide decades of pain-free function, the operation sometimes needs to be done again. This may be due to parts of the replacement becoming worn or loose. Other problems that can be treated through revision hip replacement surgery include the management of infection, fracture or instability of the joint.
We’re seeing more people who need hip replacements due to patients having more active lifestyles than previous generations.
Our hip consultants are in the top 1% for revision rates and so we rarely see our patients for revisions. But if you’re experiencing pain in your artificial hip joint, we can diagnose and treat it effectively - wherever you had your original hip replacement.
Who needs hip revision surgery?
If you had a hip replacement between 10 to 20 years ago, you may need hip revision surgery depending on how much daily use the joint has seen. While there's no hard-and-fast rule for when you could have a hip revision, you may need an operation if you're experiencing hip pain, instability or joint swelling.
Why may I need hip revision surgery?
The artificial implants used in hip replacements are susceptible to wear and tear and sometimes need to be repaired or replaced. If you’re experiencing pain and discomfort, a revision of your hip replacement can help minimise pain and improve the function of your hip joint.
There are three main reasons why people need hip revision surgery: dislocation, mechanical failure and infection.
Repetitive dislocation
Your prosthetic hip is similar to a natural hip in that it has a ball and socket. The ball must remain in the socket for your hip to continue to function well. Whether the ball stays in the socket is all to do with the alignment and fit of the prosthesis and the forces generated by muscles surrounding the hip joint.
Trauma to the hip or certain hip positions can lead to a hip dislocation. For most people with a hip replacement, it’s rare for this to happen. The people most at risk of hip dislocation are elderly or debilitated patients or patients who had their first hip replacement after a fracture. If your hip repeatedly dislocates, you might need surgery. This is because, the more times your hip dislocates, the more likely it is to happen again. Hip revision surgery helps prevent new dislocations.
Wear and tear (mechanical failure)
More active individuals and patients who had their initial hip replacement earlier on in their lives will find that the new hip joint wears down faster than for elderly patients. As you move, the different parts of your hip replacement will rub against one another. Over time this wears away the prosthetic. Continual, repetitive movements cause small pieces of the prosthesis to break off.
Your immune system will see these small pieces as foreign bodies, generating an immune response - a bit like an allergic reaction. This immune response can be so strong that it starts to destroy healthy bone tissue in the hip joint or can cause the components of the hip replacement joint to come loose. If this happens, you will usually need surgery to prevent bone loss. This is one of the most common reasons for hip revision surgery. You might also need a hip revision if you break the prosthesis in a fall or collision.
During surgery for this type of hip revision, the surgeon will remove the worn, loose or broken components and replace them with new implants. It’s not uncommon to use a bone graft (from a deceased donor) to rebuild the bone lost due to the original prosthetic failing.
Infection
The risk of infection after hip replacement surgery is higher during the first six weeks, but you can contract an infection at any time. Sometimes, infections in other parts of the body (for example, the mouth, gums, teeth, lungs or skin) can allow bacteria to enter the bloodstream. If this happens, there’s a small chance the bacteria can spread to your hip, infecting your hip replacement.
If your consultant suspects you have an infected hip replacement, they’ll seek to pinpoint the bacteria causing the infection. This is usually done via a hip aspiration so that fluids can be sent off and analysed. If you have an infection, your surgeon will discuss with you the best way to move forward. Whether you need surgery or not depends on how severe your infection is, whether antibiotics are likely to be effective and your general health, among other things.
You might also need a hip revision operation if you have an allergic reaction, a broken bone around the hip joint, alignment issues or if your implant has come loose. If your hip isn't functioning properly, you'll usually feel pain and discomfort. If this is the case for you, book an appointment with one of our hip consultants for an examination. They can then advise on the most effective treatment approach and whether you could benefit from hip joint revision surgery.
Can I reduce my chances of needing hip revision surgery?
Choosing a trusted provider such as HCA UK can reduce your likelihood of needing a revision. It’s well established that clinical results tend to be better when performed by higher volume hip surgeons (those who perform procedures more regularly), and at hospitals which undertake a large number of hip replacements per year.
How serious is hip revision surgery?
Hip revision surgery is a major operation. Compared to the original hip replacement, the revision is a longer and more complicated surgery. Requiring considerable planning and state-of-the-art tools and implants, hip revision surgery should only be carried out by the most experienced hip surgeons. We have several leading consultants specialising in hip arthroplasty, so you can be sure of receiving exceptional care with HCA UK.
Should I have hip revision surgery?
Your consultant will discuss your options with you. If they determine that you are not yet in need of a hip replacement revision, they may suggest pain relief, weight management or other lifestyle changes. However, hip revision surgery may be necessary if your implant is loose or broken or if you've developed an infection or allergy. Some of the benefits of hip revision surgery include:
- Pain relief
- Increased mobility and strength
- Improved coordination of your torso and leg that can help you return to normal activity levels.
When should I see a hip specialist?
If you've been experiencing pain and tenderness in your hip, it's a good idea to book a consultation with one of our specialists. We understand hip pain is frustrating, especially if you've previously had your hip replaced.
When you see one of our hip specialists, they'll work with you to discover why you might be experiencing pain or discomfort. They'll be able to advise on whether hip revision surgery is the most effective option.
How to book a consultation with one of our specialists
Our team of hip surgeons are on hand to help you regain mobility and ease discomfort. Follow these steps to book an appointment:
- Book online to confirm your appointment now or call us
- Keep your referral letter from your GP handy, if you have one. We will need it to confirm your appointment
- Have the details of your original hip replacement surgery, such as the date, location and prosthetic type, readily available
Hip revision surgery FAQs
The average lifespan of an original replacement is 10 to 20 years depending on age and level of activity. According to a study published in the Lancet, 21% of first hip revisions were revised again after 15 years.
A month before your operation, we’ll arrange for you to meet your consultant and the wider care team so you know what to expect. Your consultant will explain the procedure in detail beforehand and answer your questions. Like all procedures, there may be some risks and side effects involved. Your consultant will discuss these with you. Some of the most common complications from hip revision surgery include:
- Blood vessel damage around the hip
- A split in the femur
- Scarring
- Lung or heart complications from the anaesthesia
- Nerve damage
- Infection
- Loosening of the replacement
- Dislocation
- Leg length difference
- Weakness in the joint
Your consultant will only recommend the procedure if they judge that the benefits outweigh these risks in your case. Once you've been briefed on the potential complications, you'll be asked to sign a consent form to confirm that you want to proceed. If you’ve decided to proceed with the hip revision surgery, there are a few things you can do at home to make the recovery process easier. These include:
- Asking someone to help you at home during the first few weeks. Cooking, cleaning and washing will be much more difficult initially, so it’s a good idea to have someone ready to help you immediately post-surgery
- Remove tripping hazards from your home
- Move anything you use often to waist or shoulder level. This can be anything from food and beverages to toiletries
- Create a comfortable place to sleep downstairs. This will save you from having to go up and down stairs with your new hip.
Your surgeon may recommend visiting a dentist before your surgery to get a thorough examination and confirm the absence of any infection.
Hip revision surgery is usually performed under general anaesthetic, but other anaesthetic techniques could be used. Your anaesthetist will discuss these with you. During your surgery, your consultant will remove some (or all) of your previous hip replacement, along with any damaged bone. They'll also remove any cement holding together your previous replacement.
They'll then replace the old, worn parts of your hip replacement with new implants. The type of implants your surgeon uses will be based on several factors. Your consultant will take into account your age, activity levels and your condition to recommend the most suitable prosthetic choice. Most hip revisions use metal-on-plastic but there are also ceramic, plastic and cement-based heads. Your consultant will be able to answer any questions you may have about this choice, so it's important to voice any concerns as early as possible.
If you require hip revision surgery due to an infection, your hip revision may require two separate surgeries. The first surgery removes the artificial joint. Once the joint has been successfully removed, the infection is treated with antibiotics. Once the infection is no longer present, your surgeon will fit the new hip joint.
You'll need to stay in hospital for a few days after your hip revision surgery. This is so that your care team can monitor your progress and make sure you’re comfortable after surgery. Once they’re satisfied that you’re healing as expected, they will discharge you from the hospital to continue your recovery at home.
Your surgeon will provide you with thorough care instructions to help your recovery go more quickly. Some of the things they’ll likely recommend include:
- Taking medication - this includes pain relief medication and medication to reduce the risk of blood clots
- Elevating both legs with a pillow for four to six weeks after your operation
- Attending follow-up appointments and physiotherapy sessions regularly. You will start with one appointment every four to six weeks. As your recovery progresses, you’ll gradually have fewer appointments to attend. Eventually, you’ll only need to attend a follow-up appointment on the anniversary date of your surgery. This is to make sure your hip joint is functioning properly. Most of your follow-up appointments will require an X-ray.
When you return home, you'll need to use crutches or a walker for several weeks. It's a good idea to get these sorted before your surgery. If you don't have them already, fixing handrails in your bathroom and stairs can make moving around at home much easier.
You might want to arrange for a friend or someone in your family to help with your usual routine, including getting in and out of the shower.
The whole procedure usually takes two to three hours. It takes longer than your first hip replacement operation as it's a more complicated surgery.
You'll need to be looked after in hospital for a few days after you've had a revision hip replacement. Our physiotherapy team will help you to stand and practice walking using crutches. They'll also give you exercises that will help build the strength back up in your hips and legs.
You should be able to go home after a few days, depending on your recovery. You'll need crutches, a walker or walking sticks to get around for a few weeks. You won't be able to drive either, so you'll need to arrange for someone to collect you from the hospital. Your consultant will let you know when you can return to work or regular exercise.
You'll see your consultant for a follow-up appointment after the operation. This is to remove any stitches or staples and discuss your progress. We'll let you know what to expect from your follow-up appointment before you're discharged from the hospital.
The hip revision recovery timeline varies from person to person. Generally speaking, most people need crutches for at least a few weeks but can put weight on their hip straight away after surgery. It's important to bear in mind that it takes longer to recover from hip revision surgery than the initial hip replacement. If your orthopaedic surgeon had to cut bone or reattach muscle to tendons, you might not be considered fully recovered for around 12 months.
The first few weeks after your operation are usually the most painful. To help you manage any pain and regain mobility, you'll be prescribed medication. It's recommended that you continue taking the medication until your hip doesn't feel painful.
To give your hip a chance to heal, you'll need to restrict movement for the first six weeks. Some things to avoid include:
- Bending your hip past 90 degrees
- Twisting on your new hip when standing
- Rolling your leg towards the other leg
- Crossing your legs
- Baths (showers are best)
You should also keep wearing your support stockings for up to six weeks.
Driving should be avoided for the first six weeks after your operation. You'll need to be off any sedatives or pain relief medication that could impair your senses before you can drive again. If you feel able to drive after six weeks, sit in the driving seat of an idle car and practise firmly pressing the pedals. If you can do this without feeling pain or soreness, you may be able to start driving but should discuss this directly with your surgeon.
There are several ways you can pay for your treatment from private medical insurance to self-funding. How much your private hip revision surgery will cost depends on the complexity of the operation you need. They generally cost more than the initial hip replacement.
Why choose HCA for hip revision surgery?
- Fast access to the care you need: We'll confirm your appointment with one of our hip specialists within 24 hours. We can also provide same-day imaging if it's required
- Our consultants are industry leaders: We're ranked number one for private hip replacement surgery in London, according to the Private Healthcare Information Network (PHIN).
- Advanced surgical techniques: We can use state-of-the-art robotic technology to plan and facilitate hip revision surgeries. This means more accuracy, less pain and quicker recovery times.
- Trusted by many: 97% of our orthopaedic patients rate us as very good or excellent (2023 patient satisfaction survey).
Request a hip or pelvis appointment
We can help you make an appointment with one of our experienced hip specialists and can also make imaging and outpatient physiotherapy appointments for you if you need them.
Our hip revision surgery locations
London Bridge Hospital
27 Tooley Street SE1 2PR London
The Harborne Hospital
Mindelsohn Way B15 2FQ Birmingham
The Princess Grace Hospital
42-52 Nottingham Place W1U 5NY London
The Lister Hospital
Chelsea Bridge Road SW1W 8RH London
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.