Revision Total Hip Surgery – Dr. Pujadas

By William Pujadas, MD

Revision Total Hip Surgery

Traditional total hip replacement surgery is a predictable long lasting procedure to relieve the pain of an arthritic hip.  During that procedure, the worn out ball and socket of the hip joint is replaced with an artificial hip joint.  As with any mechanical device, a total hip may eventually fail as a result of mechanical or biological reasons.  “Revision hip surgery” is performed to repair the failed total hip procedure.

Anatomy of the hip.

Image of human pelvis anatomy.

Approximately 15 out of 100 hip replacements will require revision surgery in the lifetime of a patient.

The main reasons for revision surgery are mechanical failure such as:

  • Implant wear, loosening, or breakage.
  • Recurrent hip dislocations.
  • Infection.

Revision surgery of the hip is more complicated than a primary total hip procedure.  It is complicated by loss of bone, as well as muscle mass.  Fortunately, newer technology and advancements in prosthetic designs make revision surgery much less of a problem at this time. The prosthetic designs are lasting much longer and have less mechanical complications associated with them and can provide greater stability.

To reduce infection risk, the use of a laminar air room in which the circulating air in the operating theater is sterilized and the staff wear surgical space suits, which are similar to what astronauts use in space, the air is all recycled and maintained sterile in the environment of the surgery.  The use of IV antibiotics has also helped to minimize the risk of infection.

Total Hip Hospital Stay

Hip revision surgeries usually take approximately 2-3 hours to perform.  The hospital stay for revision surgery is usually 2-3 days depending on the exact nature of the revision surgery performed.  This is related to the weight bearing status of the patient after their surgery. Usually a home physical therapy program is carried out for approximately 2-3 weeks at which time the patient is seen back in the office for a follow up visit. Usually a formal physical therapy program as an outpatient would be initiated at that time.  The healing process from the revision surgery can take up to 6-12 weeks.

Although the recovery from revision surgery has improved greatly, there still needs to be a significant effort to reduce the incidence of hip revision surgery.  It is important that the patient is aware of the risks of infection and/or implant failure and to monitor themselves post surgery with periodic follow up visits with x-rays and examination.

Several Approaches To Treating Hip Pain With JOI Physical Therapy

Despite hip pain being a common complaint among all people, there are a few easy forms of physical therapy which can help. Exercises for core strength and stability are used to treat and prevent pain in the hips. Ergonomic education is instrumental in treating hip pain, as the way in which people sit or stand can be a contributing source of pain. Lastly and perhaps most importantly is keeping up with your health. Weight loss and maintaining a healthy body weight are always recommended in the treatment of hip pain.

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call 904-858-7045.


JOI Fracture and Injury Care Services

Author: William G. Pujadas, MD


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