Revision Hip & Knee Surgery

A painful left hip after joint replacement

People are living longer and just like a machine, a joint replacement will wear out over time. You may start to experience pain in the groin as you walk (often caused by a loose socket) or thigh pain (loose stem/thigh pin). It is extremely important to have long term follow up especially after ten to fifteen years of your hip replacement. I would be more than happy to provide a ‘joint replacement MOT’ should you request it.

Unfortunately, a very small minority patients also have a less than satisfactory procedure leading to post-operative complications resulting in continued pain, swelling, limp or dislocation (ball coming out of the socket). I have considerable experience in treating patients with these problems thanks to extensive experience working with internationally renowned surgeons pioneering in this field and would be happy to provide an opinion, recommendation and further surgery if indicated.

Revision (“Re-do”) Hip and Knee Replacement Surgery

These are very challenging operations. Fortunately, the results of these have improved significantly over the last couple of decades. Recent advances in implant technology and techniques have made these procedures quite reliable. Depending on the reason behind the revision procedure, it can take between 2-3 hours to successfully perform these operations. Unfortunately, due to the nature of these operations complication rates are also higher. I will counsel you fully before the operation so that you can make an informed decision on how to proceed.

Potential complications include infection, fracture, loosening of implants, malposition and dislocation. I must stress that I will undertake a thorough assessment and series of investigations to identify the reason behind failure of your existing joint replacement. The success of future revision surgery relies heavily of identifying the cause of the previous failure. If I do not find a reason for a failure, then I will be very hesitant to offer you any major surgery which has potentially high complications and limited chance of success.

The necessary inventory of instruments & implants to accomplish this operation is huge. Sometimes, we can run out of physical space in the operation theatre! Certainly, they are expensive operations as well. Sometimes, it may be necessary to perform this on an NHS basis and I will advise you accordingly.
Avascular Necrosis of the Hip Joint

In some cases the head of your femur loses its blood supply and the bone can collapse over time. This can lead to significant damage and even destruction of the hip joint.

In the early stages, patients experience extreme hip and groin pain but x-rays are normal. If this persists, I would recommend an urgent expert assessment by an orthopaedic surgeon for further assessment as it can progress significantly in a very short period of time causing destruction of your hip joint making future surgery extremely challenging. If caught early, it may be possible to prevent the deterioration either by medication or smaller surgery called hip core decompression.