Revision Total Hip Replacement

How Can a Hip Replacement Fail?

There are many reasons why a total hip replacement can fail. These include wear, dislocation, infection, chronic pain and loosening. Dr. Wind has extensive experience in treating failed or painful total hip replacements. Since being in practice, he has seen many patients on referral from other physicians for evaluation of problems with hip replacement.

 

xray of patient with failed revision left total hip arthroplasty with acetabular loosening and bone loss
60 yo patient with failed revision left total hip arthroplasty with acetabular loosening and bone loss
x-ray of complex revision left total hip arthroplasty utilizing a customized triflanged acetabular component
Complex revision left total hip arthroplasty utilizing a customized triflanged acetabular component

 

How Component Wear Can Develop Over Time

The most common reason why a total hip can fail is component wear. Over years of use, the constant motion at the bearing surface of a hip replacement can result in wear of the plastic and/or metal. These wear particles can cause bone loss and loosening on the prosthesis. Wear occurs with all joint replacement, however, inserting the components properly at the original surgery is the best way to keep this problem to a minimum. Once extensive component wear has occurred, often revision surgery is the only viable solution.

Other Problems Requiring Revision Hip Replacement

Other causes for failure of a hip replacement include chronic instability (dislocation), infection, loosening and implant fracture. Performing the original surgery in a proper manner can reduce the risks of these problems arising. When these problems occur, revising the original prosthesis is often the only option.

 

What is Revision Hip Replacement?

In basic terms, a revision surgery is converting a past surgery to a well-functioning hip replacement. This is due to failure of a past hip replacement. Depending on the cause of failure, either one or both of the hip components may have to be removed and replaced.

Why is Revision Hip Replacement more complex?

With scar tissue and component exchange, this type of surgery is much more technically demanding than primary (or first time) hip replacement. This is why many surgeons will refer a patient with a failed hip replacement to another surgeon who has fellowship/subspecialty training in complex joint reconstruction.

Revision surgery also encompasses challenging cases where other types of past hip surgery, such as fracture fixation, have failed and require revision to a hip replacement. In revision surgery, specialized prosthetic parts are utilized to reconstruct the hip and often bone grafting and metal augmentation is necessary.

 

Expertise to Handle Even the Most Complex Hip Replacement Challenges

Dr. Wind is proud to be able to offer solutions for patients with a failed total hip replacement or problematic past hip surgery. He commonly sees patients referred from other surgeons with complex problems after previous hip replacement surgery.

xray of 87 year old female with obvious failure fixation of an intertrochanteric fracture of the hip. fracture line is persistent and the hardware is failing in varus

 

87 year-old female with obvious failure of fracture fixation of an intertrochanteric fracture of the hip. Fracture line is persistent and the hardware is failing in varus

 

Revision Total Hip Replacement after surgery xray

 

Complex revision of failed fracture fixation to a total hip replacement in 87 year-old female. Patient now able to ambulate with full weight bearing and no discomfort

 

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