17104 Hip Revision Surgery

Overview

Hip revision surgery is an operation to fix or replace a hip implant that is no longer working well. An implant is the artificial hip joint put in during an earlier hip replacement. Over time, an implant can wear out, come loose, get infected or cause pain. When that happens, a surgeon may need to remove some or all of the old parts and put in new ones. Think of it as a repair job on a replacement hip rather than a first replacement. Revision surgery is usually longer and more complex than the first operation, and recovery can take more time.

Hip replacement is one of the most common operations worldwide, and hip revision is much less common. Only a small share of people with a hip replacement ever need a revision, and usually not for many years. Because more people are living longer with joint replacements, the number of revision operations is slowly rising.

Hip revision surgery is most often needed by older adults, because implants have had more years to wear and bones may be thinner. But it can also affect younger people who had a hip replacement early in life, people who are very active, people who have had an infection or a fall, and people whose implant causes ongoing pain or looseness.

Symptoms

Common symptoms

• Pain in the hip, groin or thigh that comes back after years of feeling fine, or pain that slowly gets worse
• Stiffness or a hip that feels less flexible than it used to
• A feeling that the hip is 'giving way' or is not steady when you stand or walk
• Limping, or feeling like one leg is slightly shorter than the other
• Clicking, grinding or squeaking sounds from the hip
• Swelling or warmth around the hip
• Being able to walk less far or needing more help with daily tasks

Causes

Main causes

• Wear and tear of the implant over many years, especially the soft plastic part that acts as a cushion
• The implant coming loose from the bone, which can cause pain and movement
• Infection around the implant, which may have happened soon after the first surgery or many years later
• Instability or repeated dislocations, where the ball slips out of the socket
• A break in the bone around the implant, often after a fall
• An allergic-type reaction to tiny particles from the implant, or, rarely, problems with certain implant materials
• Ongoing pain that does not settle and cannot be explained by other causes

Risk factors

• Having had a hip replacement many years ago
• Being very active or doing a lot of high-impact activity with an implant
• Being overweight, which puts extra load on the joint
• A previous infection, fall or complication around the hip
• Smoking, which can slow healing and raise infection risk
• Some long-term health conditions, such as diabetes, that can affect healing and infection risk
• Weaker bone quality, which can make the implant less secure

When to see a doctor

See a doctor urgently if:

• You have a fever, chills or feel generally unwell, especially with hip pain or a wound that is not healing
• Your wound is leaking fluid or pus, or is very red, hot and swollen
• You suddenly cannot bear weight on the leg, or the leg looks twisted or shortened
• You have chest pain, sudden breathlessness or calf swelling — call emergency services first if these are severe
• You have had a fall onto the hip

Book a routine appointment if:

• Hip, groin or thigh pain that keeps coming back or slowly gets worse
• Stiffness or a hip that feels less reliable than before
• Clicking, grinding or squeaking from the hip
• A feeling that one leg is longer or shorter than the other
• You are finding it harder to walk, climb stairs or do everyday tasks
• You want to talk through whether your implant needs checking

Diagnosis

Your doctor will start by asking about your hip history — when you had the replacement, what type it was, and how your symptoms have changed. They will examine how you walk, how far you can move the hip, and whether it feels stable. Imaging and sometimes blood tests help show what is happening around the implant. If infection is suspected, removing a small sample of fluid from the hip joint may be suggested.

Tests that may be done

• X-rays of the hip, often compared with older X-rays to see if anything has shifted
• Blood tests to look for signs of inflammation or infection
• A sample of fluid taken from the hip joint with a thin needle, checked for infection
• CT or MRI scans to get a more detailed picture of the bone and implant
• Sometimes a scan that uses a small amount of radioactive tracer to look for loosening or infection
• A review of your implant's records, including its type and when it was fitted

What to expect at your appointment

You may see a hip specialist (an orthopaedic surgeon) rather than only your family doctor. The assessment usually takes one or two visits and may include several tests done on different days. It can feel like a lot of waiting, but this careful checking matters: the right diagnosis helps your team choose the safest and best plan for you. Bring a list of your medicines and any old X-rays or operation notes if you have them.

Treatment

Not everyone with a painful or worn implant needs surgery straight away. Your team will first work out what is causing the problem. Sometimes the answer is physiotherapy, walking aids, weight management or other non-surgical support to keep you comfortable and mobile. If the implant is loose, infected, broken or badly worn, surgery is usually the best long-term option. The type of operation depends on the cause and how much bone is left.

Self-care at home

• Keep active in gentle ways, such as short walks, swimming or cycling, to keep muscles strong
• Use a walking stick, crutches or a frame if they help you move more safely and with less pain
• Keep to a healthy weight to reduce strain on the hip
• Follow any physiotherapy exercises you have been given
• Notice and write down what makes the pain better or worse, to share at appointments
• Make your home safer — good lighting, no loose rugs, and things you use often within easy reach

Medical treatments

Non-surgical care focuses on managing pain and keeping you mobile. Your doctor or pharmacist can discuss pain relief options that are suitable for you, and a physiotherapist can help with strength, walking and balance. If infection is found, treatment to clear the infection is needed, sometimes before any surgery. Your team will also review other health conditions, such as diabetes or blood pressure, to help you prepare if surgery is planned. You may be referred to a specialist hip team for a full assessment.

When is surgery considered?

Surgery is usually considered when the implant is loose, worn, broken or infected, when the hip keeps dislocating, or when pain and stiffness are seriously affecting your daily life and other treatments have not helped. There are different types of revision, from replacing just one part of the implant to replacing the whole hip, and sometimes rebuilding bone. Your surgeon will explain what is involved in your case, the risks and benefits, and what recovery is likely to look like.

Living with this condition

Recovery after revision surgery is usually slower than after a first hip replacement. Many people spend a few nights in hospital and use crutches or a frame for several weeks. You will likely need help at home for a while with shopping, cooking and cleaning. Physiotherapy starts early and continues for weeks or months. Most people notice real improvement over three to six months, though full recovery can take up to a year or more. Take it steadily and follow your team's advice on movement and restrictions.

Lifestyle tips

• Build activity up gradually — short, frequent walks are better than one long one at first
• Keep up your physiotherapy exercises even when you start to feel better
• Avoid high-impact activities such as running or jumping until your team says it is safe
• Check with your surgeon before returning to driving, work or sport
• Protect your hip with good footwear and by removing trip hazards at home
• Attend your follow-up appointments so any problems are caught early

Diet and exercise

Eating well helps healing. Aim for regular balanced meals with protein, fruit and vegetables, and enough calcium and vitamin D for bone strength — your doctor or pharmacist can advise on whether you need a supplement. Drink plenty of water. Gentle exercise such as walking, swimming and guided strength work keeps muscles around the hip strong and helps prevent falls. A physiotherapist can design a programme that matches your stage of recovery.

Mental health and emotional wellbeing

It is very normal to feel frustrated, anxious or low while recovering from revision surgery. Waiting for tests and coping with pain can be tiring, and needing help from others can feel hard. These feelings usually ease as you get stronger, but they are worth talking about. Tell your doctor or nurse how you are feeling — support such as talking therapies, physiotherapy groups or a patient support group can make a real difference. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis support service straight away.

Prevention

Not all revision surgery can be prevented, because implants naturally wear over time. But you can lower your risk and protect your implant. Keep to a healthy weight, stay active in low-impact ways, avoid smoking, and keep other health conditions such as diabetes well managed. Look after your general health and bone strength, reduce your risk of falls, and see your doctor early if you notice new or worsening hip pain. Attend any follow-up appointments you are offered after your original hip replacement.

Screening programmes

There is no routine screening programme for failing hip implants. The best approach is regular check-ins if your surgeon recommends them, and reporting new symptoms promptly. If you have an implant that has been flagged for extra monitoring, your hospital will contact you directly.

Complications

If left untreated

• Pain and stiffness that gradually get worse and limit walking, sleep and daily activities
• The implant loosening further, which can damage the bone around it and make later surgery more complex
• Infection that spreads and becomes harder to treat
• Repeated dislocations or a sudden dislocation, which is very painful
• A break in the bone around the implant, often after a fall
• Increased risk of falls and loss of independence

Long-term outlook

Hip revision surgery is a big operation, but for most people it brings meaningful relief from pain and helps them move more easily again. Recovery takes patience, and progress is often gradual rather than dramatic. Some people need more than one revision over their lifetime, and some continue to have some aches. Your care team will work with you on a plan that fits your health and your goals, and there is good support available along the way.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.