Introduction
Occasionally a hip replacement procedure needs to be corrected and this is referred to as a 'revision'. A revision hip replacement is generally more complex than the original hip replacement procedure, and can involve the partial or full replacement of the original artificial hip components (prostheses). In very rare cases a revision hip replacement may itself need to be revised.
Reasons for revision
There are a number of reasons why a hip replacement procedure may need to be revised, including:
Fracture near site of prosthetic joint component
Due to its proximity to the artificial hip components, this is referred to as a 'peri-prosthetic fracture'. It is generally caused by a fall or other direct trauma. It may also be partially caused by osteolysis (see below).
Loosening of prosthetic joint components
Generally, this either occurs where the artificial joint has been in place for a considerable time, or where it has been subject to significant amounts of 'wear and tear'. It may also be caused by osteolysis (see below).
Infection in / near the prosthetic joint component
The only way to treat infection in the artificial hip joint is to replace existing prostheses with new ones.
Multiple repeat joint dislocation
After hip replacement surgery a number of guidelines must be followed to minimise the possibility of hip dislocation.
Osteolysis
This is where the body reabsorbs bone tissue – it is believed to be caused by an autoimmune reaction as the immune system deals with minute wear particles that come off the artificial components and then also resorbs living bone tissue as well. Osteolysis can occur as little as 12 months after the original replacement procedure and is progressive in nature. It does not cause any symptoms when it is occurring, but it can contribute to loosening of components of the hip replacement and bone fracture.
Symptoms
Indications that an existing hip replacement may need to be revised include:
- Onset of increasing pain in the hip.
- Instability or (sometimes) multiple dislocations of the hip joint.
It is important that, once an issue with the original hip replacement is discovered, a revision procedure is carried out as soon as practicable to avoid any more severe complications.