Revision surgery
Revision hip surgery means correcting or replacing part or all of a previous hip replacement when it has failed or is causing significant problems.
Key points
- For a failed, painful, loose, unstable, infected, or broken prosthesis
- More complex than primary hip replacement
- Higher complication rate
- Recovery is less predictable
- The goal is a stable, safer, less painful hip
Revision surgery means removing or replacing one or more parts of a previous hip replacement. It may be needed if the implant becomes loose, unstable, infected, worn, painful, or damaged, or if there is a fracture around the prosthesis. More than one problem can be present at the same time.
Current registry data show that the most common reasons for single-stage hip revision in recent years include aseptic loosening, dislocation or subluxation, periprosthetic fracture, implant wear, infection, and bone loss around the implant. The exact cause matters because the investigations, operation, implants, recovery, and risks are different for each problem.
Revision hip replacement is usually more difficult than a first hip replacement. There may be scar tissue, bone loss, stretched or damaged soft tissues, infection, broken bone, or old implants that are difficult to remove. Before revision surgery, patients may need updated x-rays, blood tests, CT scan, joint aspiration, or other investigations. Some revisions require special implants, bone graft, cables, plates, or staged surgery. If infection is present, treatment may involve removing the implants, placing a temporary spacer, using antibiotics, and returning later for another operation.
Many patients improve after revision surgery, especially when the cause of failure is clear and enough bone and soft-tissue support remain. However, the outcome is less predictable than after a first hip replacement. Complication rates are higher, recovery may be slower, and the risk of needing another revision is greater. The goal is to relieve pain, restore a stable hip, improve walking safety, and preserve as much function as possible, but a revision hip may not feel as natural or as strong as a successful first hip replacement.
References
- National Joint Registry. Table 3.H15(b): Number and percentage of hip revision by indication and procedure type in last five years. The National Joint Registry 22nd Annual Report 2025.
- Mohammad O, Shaarani S, Mohammad A, et al. Patients' expectations surrounding revision total hip arthroplasty: a literature review. Arthroplasty. 2024;6:28.