HIP SURGERY

 REVISION SURGERY 

The purpose of Repeat surgery (also known as Revision surgery) is to replace or compensate for a failed Hip or Knee replacement implant. Data collected since 2004 by National Joint Registry (.pdf) confirms Mr Lawrence's success record appreciably beating the UK average,

Following a hip replacement, major complications are rare. Should a problem arise, redo surgery is complex and an experienced surgeon is therefore essential. Mr. Lawrence has undertaken over 600 revision hip replacements and will find a solution for all problem hip replacements.

PAIN

Hip replacements are generally pain-free. In the unlikely event of developing groin pain, or thigh or buttock discomfort associated with activity, the hip replacement should be checked out by a specialist as soon as possible. Pain in the upper thigh may be the earliest sign that the hip implants may have become loose or that the joint has become infected.

If you have a resurfacing hip replacement, pain may be related to an allergic  reaction to the metal debris, the ball of the hip joint may have died, minor fractures may be developing around the hip surfacing, or the joint may be infected.  Urgent assessment  is advised.

INFECTION

Features of infection include 1) heat, redness or swelling of the wound. 2) continuous fluid  ooze through the skin, 3) severe pain in the hip  and 4) unexplained temperatures. Please get yourself checked out urgently if you develop any of the above. 

DISLOCATION

If the hip joint feels unstable or has popped out of its socket on several occasions, then further surgery will be required. The hip may start dislocating because the implants have become loose or have worn out. Alternatively, the alignment and positioning of the hip replacement may be  poor and repositioning may be indicated.

IMPLANT LOOSENING

The commonest reason for a hip replacement to become painful is because the implants have loosened from the bone. Continuous jolting of the loose implant results in erosion of the bone, which in turn becomes weakened. It is therefore best to address the loose implants early.

Once the implants have been removed, the degree of damage to the surrounding bone is determined. If there is minimal damage, excellent results can be obtained by re-cementing new implants. When  there is extensive damage to the bone, grafts will be necessary to build up the deficiency.  Recovery will then be slower.

The bone graft is usually obtained from the ball of the hip joint donated by patients previously undergoing a hip replacement. The ball of the hip joint is removed at the time of surgery , irradiated to remove contaminants, and then frozen. Patients donating bone are tested to ensure that they are free from any diseases that could be transmitted through the donated bone.

The ball of the donated hip joint is broken up into small fragments and impacted at the site of bone loss. New implants are then cemented into place. It takes months to years for the grafted bone to become part of the skeleton. As a result, depending on the amount of graft used, patients may partial weight bearing for 6 weeks. The big advantage of using bone graft, especially in young patients, is that the bone stock  is eventually restored and as a result, if any future operations are required, they will be very much easier to do. On occasion, the bone loss may be so great that the whole of the thigh bone needs to be replaced by a metal implant together with grafting of the pelvis. 

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