The hip joint is a ball-and-socket joint. The ball is the head of the femur, the large bone in the top of the leg. The socket is the lower part of the pelvic bone, where the head of the femur sits. A total hip replacement is the replacement of these two major parts of the hip joint with a man-made socket, ball, and stem. This involves:

• Removing the head of the femur
• Inserting a metal stem into the end of the bone
• Attaching a ball to the head of the stem
• Cleaning out the old hip socket by removing any cartilage and damaged bone
• Inserting a new hip socket and liner

An artificial hip joint typically lasts about ten to fifteen years, depending:

• On the level of activity
• Daily use of the joint
• Other factors

Revisions of a total hip replacement are more common in patients who had a hip replacement with a metal-on-metal hip implant or those who are:

• Younger and more active (due to increased wear and tear)
• Obese (increased wear and loosening)
• Recovering from a hip replacement due to inflammatory arthritis, avascular necrosis (death of bone) or a previous hip fracture (increased risk of loosening)

Revision of a total hip replacement involves:

• Removing the previously inserted socket, ball and stem
• Cleaning out the surrounding area
• Inserting a new socket, ball and stem

Your healthcare provider may recommend a revision of your total hip replacement if you have:

• Severe pain in an artificial hip joint that has not responded to treatment and stops you from doing your normal daily activities (i.e., walking, normal household tasks and other usual daily activities)
• Signs of infection in an artificial hip joint (i.e., redness, warmth, drainage from incision and fever)
• An unstable artificial hip joint that causes limited, uncomfortable or painful movement of the hip joint
• Hip revision surgery can fix the problems above, decrease pain and allow normal hip movement and stability.

Prior to the surgery, tell your healthcare provider about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before the surgery. These may include:

• Medications you should not take before the surgery, such as blood thinners or aspirin
• Regular medications you should continue to take on the day of your surgery
• How many hours you should stop eating and drinking before surgery
• How to prepare your home for your return after you are discharged
• Instructions on getting around with a cane, walker or crutches

If you are a smoker, you should quit smoking, as it can interfere with your healing and recovery.

During surgery, you will receive anesthesia to keep you comfortable and pain free.

• General anesthesia is the most common type of anesthesia for a revision of a total hip replacement.
• With general anesthesia, the anesthesiologist puts you into a deep sleep. You will not be able to see, hear or feel anything.

After surgery, you will probably need to stay in the hospital for a few days to recover.

• Most people are able to go home after discharge from the hospital. However, some need to go to a rehabilitation hospital for a few days.
• Your recovery can take a while and will include a lot of exercise and physical therapy.
• You will need pain medication and help at home while you recover.

What should I ask my healthcare provider before having a revision of my total hip replacement?

• What is my diagnosis and reason for the surgery? What nonsurgical alternatives are available to me? How will the surgery affect my daily life?
• Why does my artificial hip need replacement? How long do artificial hip implants like mine last before they require replacement? Was my earlier hip implant a metal-on-metal hip implant?
• What tests do I need? What is the reason for those tests? Will the test results change my treatment plan?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• What kind of anesthesia will I have? What are the possible side effects?
• What type of recovery should I expect and how long will it take?
• When might I start to see improvement in my symptoms?
• What are my follow-up plans and what symptoms should I report before my next appointment?
• How many hip replacement surgeries have you done? What is your success and complication rate?
• How many hip revisions have you done? What is your success and complication rate?

Make sure you understand your treatment plan, any possible alternatives and what medications are recommended (including possible side effects). Do not forget to make arrangements for transportation to and from the facility and for help at home. Your surgeon should also let your primary care physician know the details of your surgery and treatment plan.

Source UHC.com

Also known as:

Total Hip Replacement

THR

Revision

Replacing Hip

Repair Hip

Osteoarthritis

Hip Replacement - Revision

Hip Replacement