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Total Hip Joint replacement (THR) is a mostly successful procedure and usually results in allowing people to live normal lives without chronic pain and stiffness in the hip.[1] Failure rates stand at around 1% in the first 15 years following THR.[2] A 2018 report found that between 2007 and 2017 the rate of THR revision increased by 30% in the age group 45-64, mainly due to use of metal on metal implant at this time with a high mechanical failure.[3]
Revisional Total hip replacement is performed when the initial THR needs to be replaced. The surgery is a longer more complex surgery as the amount of bone available is reduced, the prosthetic parts are often larger/longer and extra bone is often required ( allograft from bone bank or artificial bone). This type of surgery has a slightly higher complication rate and the prosthesis usually has a shorted life span.[4] A 2018 research article found that revision arthroplasty is associated with higher infection rates , lower outcomes and higher financial expense compared to primary replacements.[5]
Indication
Revisional Total hip replacement (THR) is performed when the initial THR has a major problem. This may arise due to
Wearing out of THR
Loosening of THR
Infection
Metallosis ( a condition involving deposition and build up of metal debris in soft tissue in the body, particularly in regard to metal implant wear and tear in joint replacements)[6]
The primary reason for revision hip replacement surgery is pain. This may be due to: plastic wear; dislocation; osteolysis; periarticular fracture; infection; hardware of components causing irritation.[9]
This follows the same protocol as Total Hip Surgery ( see Physiopedia page THR ).
Be aware however that the surgeon may have specific advice to follow, especially as this is a more complex procedure and not all orthopaedic surgeons will take on this surgery. eg Non or partial weight bearing to commence.
The total rehabilitation phase in hospital and home may also be longer due to more extensive damage and repair.
Before I had my THR when I went dancing I did the "Twist and Shout" Now. I don't.!