What is a hip revision?
A hip revision is a procedure done when a total hip replacement fails. It is essentially a "redo" of the first surgery. There are many different modes of failure for a hip replacement. A failed surgery or implant can lead to significant pain and disability. Our surgeons are able to fix the smallest to largest hip replacement failures. We perform complex hip revision surgery on patients from all over the southeastern United States.
Why do hip replacements fail?
There are numerous reasons why hip replacements fail. A variety of factors must be assessed in order to delineate what the problem is with the joint. Patients may suffer from infections (less than 1%), failure of the plastic, implant failure, loosening after a fall, allergic reaction, wear of the plastic over many years, etc. When hip joints fail, patients can be severely debilitated. Our group believes in identifying the problem, explaining the root cause of the problem, then addressing it to our patients satisfaction. From infection to breaking a bone around the implant, our Atlanta hip revision surgery specialists are all capable of restoring your function! Turn no further, we're here to help. Click to fill out our survey and let us review what's wrong with your hip replacement.
How do I know if my hip replacement failed?
Infection
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to erradicate the infection and get you your life back!
Component Positioning Problems
In total hip replacements, poorly placed components with incorrect rotation can lead to instability. Our surgeons will take X-Rays and see if this is part of the problem leading to weakness, popping, clicking and the feeling of the hip subluxing (shifting).
Plastic Wear
Think of the plastic in a hip replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
A hip replacement can dislocate, meaning that it pops out of place. There are multiple reasons for hip dislocations. The variables are the placement of the cup (socket), the femoral component (stem) and the surgical approach taken to the hip. Surgeons who do the posterior hip replacement surgeons have a higher rate of dislocation. Although arguments are made against it by posterior approach surgeons, the data does not support them. Posterior hip replacements have a significantly higher rate of dislocation than an anterior based approach to the hip. Hip dislocations most commonly occur because of positioning as well as the surgical approach taken to the hip.
Stiffness
Luckily with hips, it is extremely rare that a hip joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," may need to be performed.
Heterotopic Ossification
Albeit rare, after hip replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation as to why this occurs. However, this can be a significant source of stiffness and can severely limit patient mobility. We offer treatment for patients who develop stiffness after heterotopic ossification.
Component Failure
Extremely rarely, the components may fail or dissociate. In this rare condition, the surgeon must replace these components. With older implants and first generation ceramic hips, the actual head that was used can shatter. Luckily, that is rarely the case as the new generation of implants have not had this problem.
The joint may get a bacterial infection that will bind to the implant. The bacteria may then create a "sugar shell" and make it resistant to your immune system as your immune system can't get rid of the encased bacteria. This is known as a biofilm. This type of problem with joint replacements is devastating. Our surgeons are equipped with the best antibiotics and work with infectious disease teams to erradicate the infection and get you your life back!
Component Positioning Problems
In total hip replacements, poorly placed components with incorrect rotation can lead to instability. Our surgeons will take X-Rays and see if this is part of the problem leading to weakness, popping, clicking and the feeling of the hip subluxing (shifting).
Plastic Wear
Think of the plastic in a hip replacement as a tire. As you use the tire, the tread begins to wear out. The same thing can happen with a joint replacement. As the plastic wears out, the small pieces of plastic may actually cause a reaction that may lead to bone loss. These typically occur many years after a joint replacement. If this occurs early in joint replacement, usually the implants have not been placed correctly.
Dislocation
A hip replacement can dislocate, meaning that it pops out of place. There are multiple reasons for hip dislocations. The variables are the placement of the cup (socket), the femoral component (stem) and the surgical approach taken to the hip. Surgeons who do the posterior hip replacement surgeons have a higher rate of dislocation. Although arguments are made against it by posterior approach surgeons, the data does not support them. Posterior hip replacements have a significantly higher rate of dislocation than an anterior based approach to the hip. Hip dislocations most commonly occur because of positioning as well as the surgical approach taken to the hip.
Stiffness
Luckily with hips, it is extremely rare that a hip joint may become stiff after surgery. Phenomena where extra scar tissue builds up is called "arthrofibrosis." This term, when dissected means "arthro"- joint, "fibrosis"- scar tissue. When joints become stiff, they lose function and become hard to mobilize. Grueling therapy may be required as well as a procedure called a "manipulation under anesthesia," may need to be performed.
Heterotopic Ossification
Albeit rare, after hip replacement, unwanted extra bone may deposit around the joint. We do not have a good explanation as to why this occurs. However, this can be a significant source of stiffness and can severely limit patient mobility. We offer treatment for patients who develop stiffness after heterotopic ossification.
Component Failure
Extremely rarely, the components may fail or dissociate. In this rare condition, the surgeon must replace these components. With older implants and first generation ceramic hips, the actual head that was used can shatter. Luckily, that is rarely the case as the new generation of implants have not had this problem.
Is your hip replacement painful? Let our Atlanta Bone & Joint hip revision surgery specialists look into it more. Fill out our survey and a team member will get back to you within 2 business days.
*Please note we can not make a diagnosis over the phone and you will most likely need to schedule a visit.
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