Do I Need Revision Hip Replacement Surgery?

The hip supports the body’s movement and upholds the structures of the upper and lower body. Your hip pain may have crept up over time, unnoticed or undiagnosed until it impaired activities in your professional or personal life. Routine, low-impact movements may have become more difficult. Did you have a hip replacement 20 years ago? Are you now starting to experience that same pain again? Regions where pain may be centralized include the thigh, inside of the hip joint, groin area, outside of the hip, or buttocks. Maybe you noticed yourself limping, or that you experience aches that worsen during exercise.

When your range of motion is compromised and the conservative hip treatment you have already sought is not improving your condition, it may be worth it to investigate more aggressive treatment methods. You may be ready for a revision hip surgery.  An appointment with an orthopaedic surgeon will help you answer the question that’s been keeping you up at night: “Do I need revision hip replacement surgery, or is a total replacement a better fit for me?”

Joint Replacement Candidacy Fast Facts:

• Causes of hip pain include: osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, avascular necrosis, or fractures.

• Candidates for hip replacements have a wide range of varying pain symptoms that range in consistency, location, and increased sensitivity during particular activities or times of day.

• Discomfort or pain while sitting, lying down, or sleeping at night is a sign that nonoperative treatments may not be adequate for one’s condition and alternate treatments must be considered.

• Everyday activities and work are compromised due to disability or pain and inflammation.

• Nonsurgical treatments like lifestyle changes have already been explored and implemented, including: weight loss, activity modification, mobility assistive devices, physical therapy, and possibly anti-inflammatory medication or cortisone shots.

• An orthopaedic surgeon will endorse a patient’s joint replacement treatment plan and will supervise and support the patient through surgery and rehabilitation.

What Are My Options?

An orthopaedic doctor will assess your medical history, activity level, current health, symptoms, and hip condition. Progression of existing hip pain or disability will be discussed, as well as, a patient’s eligibility for different types of treatment plans. Patient compliance is an important part of patient eligibility because surgery rehabilitation is lengthy, involved and necessitates the help of others during the initial healing stages post-surgery when mobility is compromised. The three most common procedures are:

Total Hip Replacement Surgery: Also known as a total hip arthroplasty, this procedure is the first surgical procedure available to a patient with severe hip pain. In it, mechanical prosthetic parts are implanted to replace the body’s damaged “ball and socket” components to relieve pain and increase mobility and quality of life. Theses prosthetics are cemented or pressed into place to suit the quality and strength of an individual’s hip and femur bones. The femoral head, damaged socket, and cartilage are all removed. A surgeon can adjust their surgical method to suit the patient’s needs, and can either approach the procedure with minimally invasive or traditional hip replacement techniques.

Hip Resurfacing Arthroplasty: Unlike a traditional hip replacement, during hip resurfacing the femoral head of the femur bone is not removed but replaced with a prosthetic cap to permit an implant replacement when the prosthetics wear with age and use. This method has a greater capacity for adjustments over time if a second revision surgery is needed.

Revision Hip Replacement Surgery: This procedure is reserved for patients that already have existing prosthetics from a previous hip replacement surgery. Revision hip replacement is the exchange of the original former “ball and socket” prosthetics for new components. The surgical methods available to revision replacements are identical to those used in traditional and resurfacing methods, but the operation has an added layer of complexity. The new implant is necessary in cases where the original prosthesis presented problems like wear and tear or increased pain over the decades. An implant that is 20 years old may have reached its lifespan, and could need replacing. In rare instances, a revision hip replacement is necessary when a patient experiences emergency repetitive dislocation, mechanical failure such as loosening or breaking, or infection. Whether the revision hip replacement serves to mitigate and resolve the risks presented by hip replacements or is implemented to restore a patient’s mobility and hip joint health, the surgeons at Rothman Orthopaedic Institute will assess a patient’s revision hip replacement surgery candidacy on a case-by-base basis.

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