Revision hip surgery is carried out for a variety of reasons. These can include the original hip wearing out, the presence of deep infection, recurrent dislocations and fracture around the hip replacement. Because of the variety of indications, both the investigations and the surgery must be tailored to each patient.
Patients tend to present with a history of pain around the hip, it may be constant or sometimes it is only there when they walk or weight-bear on the hip. They may have noticed that the leg is shorter or there may be episodes where the hip feels like it is coming out.
All patients are examined thoroughly to look for abnormalities. They will then undergo standard x-rays to look for loosening. They will have specific blood tests to look for infection or other abnormalities. They may then go on to have special scans such as Bone scans (to confirm loosening) or White cell scans (to check for infection). Before carrying out a revision, Professor Fehily will usually carry out an aspiration of the hip to obtain some joint fluid to check for infection. This is usually done under general anaesthetic.
Revision hip surgery does carry significant risks. They are roughly double that of first time hip replacements. They include deep infection, sciatic nerve injury (causing foot drop), femoral nerve injury (causing weak quads), bleeding, leg lengthening, dislocation, fracture and general systemic risks such as stroke, myocardial infarction and thrombosis (blood clots).