Why does a hip replacement require a revision?
December 5, 2016
Surgery is not a pleasant prospect for most patients. For active adults with arthritis, it can mean the difference between restricted function and pain free movement. Sometimes a revision is required a few months or a few decades after a hip replacement. Below are some of the most common reasons that hip replacement revision surgeries are required.
Chronic pain is the primary reason for revision. Sometimes the cause of chronic pain is unclear. More often than not, however, it is easy to identify and fix the problem. Hips with an obvious cause for pain in general do better after surgery. Since we want you to live an active lifestyle without pain, my team and I do a thorough job identifying the causes of pain. If we know what the primary causation is, we are able to fix that problem.
Another reason is wear of the components: This is one of the easier revisions where only the plastic (polyethylene) insert is changed. In general, 80-90% of hip replacements will last 15 years.
Put simply, this means the hip is popping out of place. A properly sized hip replacement will not pop out of socket, so this is indicative of a problem. We use male and female components to compensate for the differences in anatomy.
A dislocation may manifest as the loosening of either the ball (femoral ) or socket (acetabular) component. This usually causes pain, but the pain may appear to be asymptomatic. For this reason, you must have your joint followed up for life. There can be changes on X-rays that indicate that the hip needs a revision, despite having no pain and no symptoms.
Infections are usually discovered due to pain. It is possible to discover an infection as part of an acute fever or generally feeling unwell.
Osteolysis (bone loss or reverse ossification):
Bone loss can occur when particles are released into the hip joint. These particles act like sandpaper and result in bone being destroyed.
Pain from hardware: Although rare, sometimes cables or wires cause irritation. This may manifest itself in other ways, however, usually pain and discomfort are due to other factors.
My team and I do our best to ensure perfect results from your hip replacement surgery. Most of the revisions I perform are on hip replacements I did not perform. This list is not meant to scare you, rather, to provide you with a resource to recognize when it may be necessary to consider a revision.
If you are experiencing any of these problems or pain after your hip replacement, please contact me. My team and I will make sure that we identify and address your problems. We will work with you to determine the best method of care.