In total hip revision surgery, also known as revision total hip arthroplasty, the surgeon removes a previously implanted artificial hip joint, or prosthesis, and replaces it with a new prosthesis. Total hip revision surgery may also involve the use of bone grafts. The bone graft may be an autograft, which means that the bone was taken from another site in the patient’s own body; or an allograft, which means that the bone tissue came from another donor.
Unlike standard THR, however, total hip revision surgery is a much longer and more complicated procedure. It is not unusual for a total hip revision operation to take 5 to 8 hours. The most critical factor affecting the length of the operation is the condition of the bone tissue in the femur (thigh bone).
Who is a candidate?
Candidates who have previously undergone THR, but have experienced complications from it or simply have a damaged prosthetic from wear and tear or infection.
Who is not a candidate?
Candidates who still have a functioning prosthetic do not require revision surgery.
Like other surgeries, total hip revision requires certain general surgery procedures such as preoperative blood testing, use of prophylactic antibiotic medications, and cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
Your home should be modified to be more comfortable and ensure a safe and rapid recovery. It is a good idea to move your bed to the first floor and to get rid of hazards such as loose rugs.
A 3-4 day hospital stay is usually required. You will be prescribed pain medication to manage post-surgery pain. The incision site will be closed with staples, which will be removed 2 weeks after surgery. You will need to prepare for the longer-term recovery process at home. It is wise to hire at-home care help or enlist the help of family or friends in the first few weeks after the surgery.
Performing light activity will be essential to the recovery process, but if necessary, a walker or cane should be used. Full hip movement should be regained after about 6 weeks.
Physical therapy will help you adjust to the new prosthetic. About 6 months after the procedure, you should be able to walk without a limp. A year of physical therapy will help you adjust fully to the new hip replacement.
As with any surgery, there are risks of complications related to infection or adverse reactions to anesthesia. Other known complications include blood clots, fracture of the femur or thigh bone, dislocation, and change in leg length. As revision surgery is more intensive and requires a longer amount of time under general anesthesia, there is a higher complication rate. In the process of replacing the prosthetic, further bone loss may occur.
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