Revision hip replacement is an operation to replace or repair a hip replacement that has worn out, loosened, or failed. It is a more complex procedure than a primary hip replacement, requiring specialist surgical expertise.
The previous incision is usually reopened. The failed or worn components are removed, which may require special instruments. Bone defects are assessed and may need bone grafting or augmentation. New implant components are inserted, often larger or specialised revision designs. The operation is longer and more complex than a primary replacement, typically taking two to three hours or more.
Revision may be needed for implant loosening (the most common reason), wear of the bearing surfaces, recurrent dislocation, periprosthetic fracture, infection, or adverse reaction to metal debris. Pain and deteriorating function are the usual presenting symptoms.
If symptoms are mild, observation and monitoring with regular imaging may be appropriate. Pain management and activity modification can provide temporary relief. However, once an implant has failed, revision surgery is usually the definitive treatment.
Thorough pre-operative assessment. Additional imaging (CT scan, bone scan) is usually required. If infection is suspected, blood tests and aspiration of the joint may be performed. Optimisation of health before this more complex procedure is particularly important.
The aim is to restore a pain-free, functioning hip. While most patients experience significant improvement, outcomes are generally less predictable than primary replacement. Revision implants may not last as long as primary implants, and recovery can be slower.
Recovery is slower than primary hip replacement due to the complexity of the surgery.
May be more difficult to match leg lengths precisely in revision surgery.
Greater blood loss is common with revision surgery. Blood transfusion may be required.
Higher risk than with primary replacement, approximately 5–10%.
Higher risk than primary surgery, approximately 2–5%.
Higher risk of periprosthetic fracture during the procedure due to bone loss.
Scar tissue makes nerve identification more difficult.
Revision implants may not last as long as primary implants.
Usually general or spinal anaesthesia. The anaesthetic team will plan for the longer operation and potential blood loss.
Hospital stay is typically longer than for primary surgery — three to seven days. Weight-bearing and movement restrictions may apply depending on the surgery performed. Physiotherapy is essential. Full recovery takes six to twelve months. Mobility aids may be needed for longer.
Close follow-up with wound checks, X-rays, and surgeon review at two weeks, six weeks, three months, and one year. Long-term surveillance is particularly important.
Yes. Revision surgery is more complex and carries higher risks of complications than primary hip replacement. However, it is still a well-established and generally successful procedure.
Revision implants typically last 10–15 years, though this varies. Longevity depends on bone quality, implant type, and activity level.
Yes, recovery is generally slower than after a primary replacement. Patience and dedication to rehabilitation are important.