Unfortunately, hip replacements can fail for a number of reasons. The most common are wear and bone loss, loosening, dislocations, infection and fracture. Some hip replacements never feel right after the first operation; this maybe becasue of malpositioning, failure to attach or leg length problems.
If revision surgery is to be contemplated, it is really important to come to an accurate diagnosis as to what is wrong with the original hip replacement. Mr. Miles will go through your history carefully and examine the hip and surrounding joints. You may need investigations including X-rays, scans and blood tests to get the diagnosis right.
Once an accurate diagnosis has been reached, the right methods of reconstruction can be established and Mr. Miles will go throguh the details with you, including the benefits and risks.
If the reason for failure is infection, this usually requires what is known as 'two stage revision'. The first stage is removal of the infected implants together with sampling for bacteria and insertion of antibiotic cement. This is followed by an interval of treatment with antibiotics until the infection has settled. This is typically between six weeks and six months. Following this, the reconstructive second stage is carried out where definitive implants are inserted and attached to bone.
If the cause of failure is not infection, one stage surgery can be carried out, in which the failed implants are explanted and the reconstruction is performed at the same operation.
There are multiple options for reconstruction depending on the degree of bone loss, the strength of remaining bone, function of hip muscles and general health of the patient. Mr. Miles will explain which options are best for you and why.