Revision Hip Replacement: When and Why It's Needed
Revision hip replacement — replacing a worn, loose, or problematic original implant — is sometimes needed years after the initial surgery. While most hip replacements last fifteen to twenty years or more, revision becomes necessary for some patients. Understanding when and why revision is needed helps patients recognise problems early and prepare for the procedure.
The most common reason for revision is loosening — the implant gradually separates from the surrounding bone over many years. This occurs as the bone responds to the presence of the implant and to microscopic wear particles, which can stimulate bone resorption. Loosening typically presents as new pain, particularly on weight-bearing, that gradually worsens. If you experience new hip pain months or years after replacement, contact your surgical team for assessment.
Infection is another reason for revision. Infections can occur early (within weeks of surgery) or late (months or years later, often from bacteria entering the bloodstream from another source, such as dental work or skin infections). Infection around a joint replacement is a serious complication requiring specialist treatment, often involving a two-stage revision (removing the infected implant, treating with antibiotics, then inserting a new implant once the infection is cleared).
Dislocation — the hip joint coming out of place — may require revision if it recurs. A hip that dislocates repeatedly may need revision to improve stability, often involving changing the position or size of the implant components.
Wear of the bearing surface (the part of the implant where the ball and socket meet) may require revision if it causes pain or produces wear particles that damage surrounding bone. Modern implant materials have significantly reduced wear rates.
Revision surgery is more complex than primary replacement. It takes longer, may require bone grafts to rebuild lost bone, and has a longer recovery period. Physiotherapy after revision is particularly important and may be more gradual than after primary replacement.
Our hip replacement physiotherapy service provides rehabilitation after both primary and revision hip replacement. Our post-hospital rehabilitation service supports the longer recovery often needed after revision. Our elderly physiotherapy service addresses the additional factors affecting older patients, while our falls prevention programme supports patients with balance concerns after revision.