Revision Total Hip Arthroplasty

Revision total hip arthroplasty (THA) is a surgical procedure that involves replacing a previously implanted artificial hip joint with a new one. This procedure is typically performed when the initial hip replacement has failed or is no longer functioning properly.

Indications for Revision THA

• Loosening of the implant: When the artificial joint becomes loose, it can cause pain and instability.
• Infection: If the initial implant becomes infected, revision surgery may be necessary to remove the infected tissue and replace the implant.
• Wear and tear: Over time, the artificial joint can wear out, causing pain and stiffness.
• Dislocation: If the artificial joint dislocates, revision surgery may be necessary to stabilize the joint.
• Fracture: If a fracture occurs around the implant, revision surgery may be necessary to repair the fracture and replace the implant.

Surgical Procedure

The surgical procedure for revision THA typically involves the following steps:

1. The surgeon makes an incision in the hip area to access the artificial joint.
2. The old implant is removed, and any infected or damaged tissue is cleaned out.
3. The bone is prepared to receive the new implant, which may involve removing any damaged bone or tissue.
4. The new implant is inserted, and the surgeon ensures that it is properly aligned and secured.
5. The incision is closed, and the patient is taken to the recovery room.

Types of Revision THA

There are several types of revision THA procedures, including:

• Acetabular revision: This involves replacing the socket portion of the implant.
• Femoral revision: This involves replacing the stem portion of the implant.
• Linier exchange: This involves replacing the plastic liner that surrounds the metal ball.
• Head and neck revision: This involves replacing the ball and neck portion of the implant.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with revision THA, including:

• Infection
• Bleeding or hematoma
• Nerve damage
• Fracture
• Dislocation
• Loosening of the implant
• Wear and tear of the implant

Recovery and Rehabilitation

After revision THA, patients typically require several weeks or months of recovery and rehabilitation. This may involve:

• Pain management with medication
• Physical therapy to improve range of motion and strength
• Use of assistive devices, such as a walker or cane
• Avoiding heavy lifting, bending, or strenuous activities

Outcomes and Prognosis

The outcomes and prognosis for revision THA vary depending on the individual patient and the reason for the revision. In general, patients can expect:

• Improved pain relief and function
• Increased mobility and range of motion
• Reduced risk of complications, such as dislocation or loosening
• A longer lifespan for the new implant