If all or part of your existing hip replacement has failed, worn out, loosened, or is infected or causing pain, you will need to undergo complex revision surgery.
Revision hip replacement surgery can vary greatly in scope and magnitude depending on the amount of damage that needs to be repaired, however in general it is a little more complex than a primary replacement as there is less existing bone to work with.
In some cases, minor revision surgery can be performed arthroscopically (keyhole surgery), but in many cases a full incision is required, along with what is essentially a total repeat of your initial hip replacement procedure.
The primary reason for complex revision surgery is to alleviate pain caused by the damaged replacement site. Being artificial, the existing prosthesis is unable to heal, and more severe complications can arise if the problem area is left untreated.
Complex revision surgery is generally more demanding than initial hip replacement surgery as bone quality around the prosthesis can be lower. This means that operations tend to take longer, as they can involve the need to remove existing implants and/or applying bone grafts.
In-patient stay: Average 5-7 days
Walk (with stick): Within 2-3 weeks (ideally)
Walk (unaided): By 6 weeks (usually)
Due to its comparatively complex nature, revision hip surgery carries with it a slightly higher incidence of complications than initial hip replacement surgery.
These complications are often the result of weakened bone structure around the replacement area, and can include fracture, dislocation and infection. Having previously had a hip replacement, you will however be familiar with the risks and recovery process, so try to be as prepared as possible.
As with any surgery, there are other inherent risks to be considered, including blood clots, wound or scar irritation, unequal leg length, nerve damage, increased pain, dislocation, repeat failure of the joint, heart attack, stroke or death.
Rest assured that you will be in the safe hands of Dr. Letchford and his surgical team, and that every measure will be taken to minimise the chance of side effects or complications from occurring.
Prior to your surgery, there are several things that both you and Dr. Letchford will need to do to ensure everything goes smoothly before and after the operation.
You should cease taking any blood-thinning or anti-inflammatory drugs, as well as any herbal or natural remedies you are taking, at least 10 days before your surgery.
You will undergo a routine medical examination to make sure you are well enough health for the operation, and to identify any factors that might cause issues down the line, including body weight and existing infections or skin conditions.
Dental work can introduce bacteria into the bloodstream. To safeguard against the chance of developing an infection, please have any dental work done well before or after your surgery. You may need to take preventative antibiotics for a few months to a few years after your surgery to protect against the risk of infection.
You will be sent for routine blood work to confirm you are healthy enough to undergo surgery. We may also perform heart checks or additional scans if the need arises.
To help make your return home easier, it's a good idea to make preparations, as you will have limited mobility after surgery. You might consider planning for loved ones to help you with daily tasks, and to arrange for furniture to be rearranged to help you get about easier.
It is recommended that you stop smoking for as long as possible before your surgery, as it can encourage clots while hampering circulation and oxygenation of the blood.
After your surgery, try to take things slowly. Use a walking aid and try to avoid stairs. Try not to cross your legs, turn your feet strongly inwards or outwards, or bend your hips more than 90 degrees. You may also be advised to sleep with a pillow between your legs.
Keeping your wound dry and well dressed is very important. Make sure you change your dressing as instructed, and keep an eye out for any changes, including fever, chills, tenderness, excessive fluid, or increased pain.
You will be given a combination of anti-clotting drugs and a pressure bandage to help prevent clots from forming. If you notice any shortness of breath or unexplained pain, contact your doctor immediately.
You may experience some loss of appetite following surgery. To give yourself the best chance at a speedy recovery, try to eat a healthy, balanced diet and keep your fluid levels up.
You will be appointed a physiotherapist who will help you to understand what kinds of exercises you need to do to regain strength and mobility, and explain what you can and can't do with your new hip. It is important that you ease yourself back into light daily activity as soon as you can.
For more information on what to expect from your complex revision surgery, please take the time to read through the resources available at the American Academy of Orthopaedic Surgeons website.