Revision Hip Replacement Surgery
About Revision Hip Replacement Surgery
Hip replacement is one of the most reliable and effective surgeries in any field of surgery available today, however in a very small percentage of cases, a problem occurs that may need further surgery.
Repeat joint replacement is called ‘revision surgery’ and is a sub-specialty practice that may require a high level of medical support such as intensive care, as well a highly experienced surgical and medical team.
Revision hip replacement involves exchanging one or all the components of a person’s hip replacement and treating any other associated problems such as infection or loss of bone from around the hip.
Revision hip replacement surgery can be undertaken for various reasons, usually to treat a complication that has occurred with the person’s hip replacement, such as:
Wear of one or all the components; this tends to happen over time as the components get older
Fracture of bone around the hip replacement (peri-prosthetic fracture)
Dislocation or repeated dislocations of the hip replacement
Loosening of one or all the components (prosthetic loosening)
Infection around the hip replacement (peri-prosthetic infection)
Leg length discrepancy
Excess wear from metal-on-metal hip replacements, leading to destruction of bone and tissues around the hip replacement, and possibly medical complications as well.
Given that revision hip replacement surgery can be required to treat many different problems, the nature of this surgery is highly variable in its complexity, with some problems requiring only relatively short routine treatments, while others may require lengthy hospital admissions with multiple complex operations and extensive medical therapy.
The decision to operate and the planning required can sometimes be very complicated, and experience in this field is vitally important.
Despite being repeat and sometimes highly complex surgery, the results of revision hip replacement are generally very rewarding for the patient, with improved function and mobility, decreased pain, and a greater quality of life.
What to expect after revision hip replacement surgery
After surgery, you will be transferred to the recovery room, where hospital staff will monitor you as you wake up after the anaesthetic. You will then be taken back to your hospital room.
Walking and weight bearing is encouraged immediately after surgery. The day after surgery or sometimes on the day of surgery, physiotherapists will give you exercises to improve your recovery. It is very important to follow these exercises in hospital and continue these at home to ensure the maximum result from your surgery.
Patients are usually hospitalised for approximately three to five days before returning home. It is rare for patients to require inpatient or outpatient rehabilitation after hip replacement, however rehabilitation requirements will be discussed with you by the hospital’s rehabilitation coordinator during your admission.
You will initially be using two crutches or a walking frame. You will use these for two to four weeks, followed by a single crutch held in your opposite hand for a further three to six weeks, or until you are able to walk normally without a limp. You will be taught the proper techniques for simple activities of daily living, such as bending, sitting, and using stairs, to prevent injury to your new hip such as dislocation. You should sleep with a pillow between your legs for up to six weeks to prevent your legs from crossing. Avoid sitting in low or deep chairs and bending over.
Some pain and swelling around the hip and thigh is expected, and you may even notice some swelling in your lower leg and foot.
Caring for your wounds after revision hip replacement surgery
The dressing over your wound will need to remain intact, clean and dry for two weeks after surgery. You may shower, but do not have a bath or swim until you see Mr Patten in his rooms at your post-operative appointment and has cleared you for such activities. You should avoid getting the dressing wet in the shower. If the dressing begins to lift, use tape to stick the dressing back down. A small amount of bleeding into the dressing is normal. Resting, elevating the leg, and applying ice can significantly help reduce swelling.
Mr Patten almost always uses dissolving stitches to close your wound, which will not need to be removed. For further information regarding wound management, please read the ‘post-operative wound management’ leaflet provided to you by our rooms before surgery.
Managing pain after your hip replacement surgery
Pain is a normal part of the healing process after surgery and will slowly improve over time. In the early days following surgery you should rest and elevate the leg, as well as regularly ice your hip and thigh, as this will all significantly help to reduce pain and swelling.
On discharge from hospital you will be provided with some pain relief for pain control. For ongoing pain relief requirements, we suggest you arrange an appointment with your GP to obtain a prescription. After surgery you should take pain relief as long as you have pain, particularly when walking or at night.
If you are concerned about your level of pain, please do not hesitate to contact our rooms for reassurance and to rule out a rare complication.
Recovery from revision hip replacement surgery
You will generally feel quite comfortable after four weeks, and almost fully recovered after three months from surgery. Patients tend to regain the last subtleties of their recovery in the three to six months after that.
The average time before you can drive following a right hip replacement is four to six weeks, and two to four weeks for a left hip replacement, depending on whether your car is manual or automatic. Generally, however, you can resume driving when you feel comfortable doing so. It is recommended to start driving for short periods of time as the muscles around your hip may become tired.
The time you may require off work varies depending on the nature of your job. For sedentary, desk-based work you will likely require three to four weeks off work, whereas for more labor-intensive duties you will need to remain off work for approximately six to eight weeks.
Prior to any dental work, advise your dentist that you have had a hip replacement, as antibiotic cover is recommended. Mr Patten does not suggest antibiotic cover for a scale and clean only.
Revision hip replacement surgery risks and complications
Given that revision hip replacement surgery can be required to treat many different problems, the nature of this surgery is highly variable in its complexity, with some problems requiring only relatively short routine treatments, while others may require lengthy hospital admissions with multiple complex operations and extensive medical therapy.
The decision to operate and the planning required can sometimes be very complicated, and experience in this field is vitally important.
Despite being repeat and sometimes highly complex surgery, the results of revision hip replacement are generally very rewarding for the patient, with improved function and mobility, decreased pain, and a greater quality of life.