Revision or redo hip surgery is required when hips fail. Hips can fail for a variety of reasons. The most common include:
Aseptic loosening – this classically happens on traditional metal on plastic hip replacements, when the plastic liner has been worn away by the metal ball. This can be associated with quite a significant amount of osteolysis or erosion of the bone by cells involved in the inflammatory process.
Infection – this occurs in 1-2% of cases and can require a 2-stage revision hip surgery with 8-10 weeks in between and a six-week course of antibiotics.
Fractures – around the implants
Dislocation – these are very difficult patients to treat. Classically dislocation occurring early is due to malposition of the implant with dislocation occurring later associated with a wide variety of factors. Treatment options include constrained cups, larger heads or reposition of the implants.
Revision or redo hip surgery is technically demanding and complex surgery. It is done when hips fail for a variety of reasons including some of the reasons listed above.
The result following a redo or revision hip surgery will never be as good as after a primary operation.
This is because there is increased risk of infection, dislocation, nerve damage together with prolonged recovery due to scarring.
I use revision implants from Stryker and use their uncemented or Trabecular MetalTM cup together with the Restoration uncemented modular stem. This implant allows me the flexibility and versatility required to treat this difficult patients sub group.