Revision of Hip Replacement

Revision hip replacement surgery is the procedure that is adopted for the patients, those have previously undergone total hip replacement surgery, but due to some injury, damage in the tissues, infection or other related factors generate discomfort and pain in the hips. Generally the duration of working of these implants in total hip replacement surgery is around 30 or more years.  But the loosening of tissues forces a patient to undergo this surgery again. Revision hip replacement surgery is considered more complicated as the whole procedure is required to be performed again. So the patient should carefully choose the surgeons as the repeated process demands expertise and skilful hands. With the availability of updated and many modern technology this revised surgery is no longer a part of person’s dream and can be performed easily.

Explaining the process further, this surgery is generally operated by replacing the hip joint by prosthetic hip implant. This surgery is performed in 2 of the types that is either hemi replacement or a total replacement. The need of this surgery arises when the total hip replacement surgery that was done around 10-20 years back is now causing problems and pains to the patient.

The total hip replacement includes substituting both the femoral head and the acetabulum however hemi arthroplasty frequently bring up to the replacement of the femoral head. These surgeries of hip joint replacement are the best option to relieve the patient from the intolerant pain which they are going through due to arthritis or sometimes for fixing vicious physical joint wounds as an important part of hip fracture management.


During the Revision of Total Hip Replacement Surgery

In the course of this revision of total hip replacement surgery, the doctors performing an operation choose the three best options. They either substitute the implants with the fresh one or eliminate the implant else restore them from the socket with great caution. Duration of the surgery varies from patient to patient and is completely subjective to the individual case. But it is generally time consuming. The time required is more than that of hip replacement surgery.

The updated form of this surgery is the Minimal Invasive Hip Replacement. With this new technology a small cut is made surrounding the hip tissues. Modern and well-designed instrument is chosen for the surgery. Implants are then implanted in the sockets very cautiously so that it is fully compatible with inner body parts of the hip such as of ligaments and bones. This is an effective method to treat damaged or injured hip.


Computer Navigated Surgery

Most updated form of surgery that is utilised with the help of computers and an infrared camera to treat adversely damaged hip is known as Computer Navigated Surgery. An image is initially taken with the aid of infrared cameras. These help computer software to virtually assist the surgeons. With the help of these images doctors select the exact location for the incision and perform an accurate surgery. This technology also helps surgeons to locate area of muscles and ligaments of the hip bone.





The reasons behind the damage of the hip joint

Hip damaged can happen to anyone. Sometimes it also has some past injuries related to it. Many of the common reasons behind these are –


  • Infection
  • Age
  • Fractures
  • Heredity
  • Arthritis
  • Calcium deficiency
  • Accidents


The symptoms

Symptoms are the noticeable factors one needs to follow. These are the general sign that indicates one or other changes happening in the body. Various signs that specifies hip damaging are-

  • Problem in walking.
  • Fever from a terrible pain
  • Unbearable pain
  • Unable to sit for a long time
  • Swelling in the hip joints.
  • Weak hip joints.


Approaches of hip replacement surgery

Approaches are the various ways that doctors adopt during the hip surgery. These factors determine the length of the incision that is resolved by the nature of their connotation with the gluteus medius as suitable with the appropriate adjustments.

These approaches are elaborated in the article below.


Posterior approach

The posterior approach is the active and the long lasting type of approach. It mainly highlights the hip joint and its capsule from the back of the organ. This technique also captivates the short external rotators and piriformis muscle off the femur.


Lateral approach

This approach of the lateral approach precisely needs length and dimensions of the gluteus minimus and gluteus medius for gain access to the joint. These are mainly used for treating hip replacement.



Antero-lateral approach

The approach that helps the body in evolving and nurture the cavity or the gap between the gluteus medius and the tensor fasciae identified as the anterolateral approach.


Anterior approach

A gap in the middle of the tensor fasciae latae and the sartorius muscle is generally developed by the anterior approach.


Minimally invasive approach

This surgery of the minimally invasive surgery basically is used by the doctors to minimise the incision size during surgery that in turn helps in decreasing elastic tissue injury and also reduce the pain.


CAS and advantages

The hip surgeries that are operated with the help of computer assisted software are designed to assist the surgeon in carrying out operation accurately. CAS systems are the combination and group of all technical equipment utilised during surgery. The initial software system designed specifically for hip replacement surgery was HIP NAV

Benefits of this surgery are-


  • smaller incisions- faster regaining and Less pain
  • Minimum duration of hospital stay
  • Minimum Scarring
  • a lesser quantity of bleeding and requirement of blood transfusion
  • Less interruption of tissue
  • Implant durability impressively enhance
  • Reducing the risk of dislocation after hip replacement surgery


Proper medicine and their regular dosage

Person who underwent hip replacement surgery needs extra care. The Patient must follow doctor’s advice very strictly. Regular follow-ups and check-ups with the doctor is a must. Proper dosage of the medicines is advised. Post operation, recovery process takes longer recovery time so proper hygiene is recommended at homes. Appropriate therapies should now become the part of daily life for such patients.


Risk factors

Every surgery has one or other side effects. Risk factors associated with hip replacement surgery are-



  • Dislocation
  • Vein Thromobosis
  • Fracture
  • Metal sensitivity
  • Inequality of leg length
  • Nerve palsy
  • Metal toxicity
  • Osteolysis

With the advancement in the field of medical sciences, everything is possible. One thing that should be kept in mind is the post-surgery care and advice should be followed strictly. These revision surgeries now have better success rate as compared to the previous times. The level of pain and recovery time will remain the same as it was during the first surgery. A person can move, sit and walk like earlier, but should be assisted during early few months after revision surgery. First few months demand extra care as the possibility for dislocation is on the high side during this period.


Dr Dhananjay Gupta

Dr Dhananjay Gupta
Director and Senior Consultant,
Orthopaedics and Joint Reconstruction and Replacement Surgeon
Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, Delhi.