Revision Hip Surgery

This is a very specialised area of practice involving the removal of hip replacements and replacing with new ones. It is specialised as often the anatomy has been distorted by previous surgery, and the bone (essential to hold the hip replacement in place) has been lost or severely damaged.

What are the reasons for revision hip surgery?

Any problem with the joint:

  1. Pain
  2. Instability (subluxation/dislocations)
  3. occasionally a noticeable difference in leg length.

There are many causes for a painful hip replacement, those that would require revision surgery can include:

  1. Infection
  2. Loose components (due to wear and tear, chronic infection, microscopic debris within the joint from wear particles at the bearing surface, fractures around the joint replacement.
  3. Toxic debris from the bearing surfaces  (this is most often seen where both sides of the bearing surface are made from metal)

What are the results of redo hip surgery like?

Generally it was believed that the first shot at achieving a good joint replacement is the best, and any redo surgery is never as good.  It is still firmly believed that the ‘first shot is the best shot’, but if it has gone wrong for whatever reason – then revision hip surgery becomes necessary.  Fortunately as surgical techniques, instrumentation and prosthesis have evolved and improved in the recent years the majority of revision surgery yields excellent long lasting results.

Here are some examples of Revision Hip Surgery X-rays:

This hip replacement was infected and became loose until dramatically the cup spun out of the acetabulum breaking the screws and the patients bone as it did so

This kind of problem requires specialist surgery, equipment and prosthesis: below is a trabecular metal augmentation system used to rebuild the acetabulum, and a long stem uncemented femoral component

Revision THR for a posterior column fracture done while attempted THR by non hip surgeon…. Cup medialised and fractured through medial wall. Treated with Posterior column plating (for fracture) and TM Cage to span large medial defect.

A cemented acetabular revision for a recurrently dislocating hip: using a special double articulating cup which grasps the femoral head to stop dislocation.

"I had every confidence in Mr Edmondson and found him very approachable, and professional."

Anonymous feedback, Montefiore Hospital

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