Hip revision surgery



Definition

Hip revision surgery, which is also known as revision total hip arthroplasty , is a procedure in which the surgeon removes a previously implanted artificial hip joint, or prosthesis, and replaces it with a new prosthesis. Hip revision surgery may also involve the use of bone grafts. The bone graft may be an autograft, which means that the bone is taken from another site in the patient's own body; or an allograft, which means that the bone tissue comes from another donor.


Purpose

Hip revision surgery has three major purposes: relieving pain in the affected hip; restoring the patient's mobility; and removing a loose or damaged prosthesis before irreversible harm is done to the joint. Hip prostheses that contain parts made of polyethylene typically become loose because wear and tear on the prosthesis gradually produces tiny particles from the plastic that irritate the soft tissue around the prosthesis. The inflamed tissue begins to dissolve the underlying bone in a process known as osteolysis. Eventually, the soft tissue expands around the prosthesis to the point at which the prosthesis loses contact with the bone.

In general, a surgeon will consider revision surgery for pain relief only when more conservative measures, such as medication and changes in the patient's lifestyle, have not helped. In some cases, revision surgery is performed when x-ray studies show loosening of the prosthesis, wearing of the surfaces of the hip joint, or loss of bone tissue even though the patient may not have experienced any discomfort. In most cases, however, increasing pain in the affected hip is one of the first indications that revision surgery is necessary.

Other less common reasons for hip revision surgery include fracture of the hip, the presence of infection, or dislocation of the prosthesis. In these cases the prosthesis must be removed in order to prevent long-term damage to the hip itself.


Demographics

The demographics of hip revision surgery are likely to change significantly over the next few decades as the proportion of people over 65 in the world's population continues to increase. As of 2003, however, demographic information about this procedure is difficult to evaluate. This difficulty is due in part to the fact that total hip replacement (THR) itself is a relatively new procedure dating back only to the early 1960s. Since the design of hip prostheses and the materials used in their manufacture have changed over the last forty years, it is difficult to predict whether prostheses implanted in 2003 will last longer than those used in the past, and if so, whether improved durability will affect the need for revision surgery. On the other hand, more THRs are being performed in younger patients who are more likely to wear out their hip prostheses relatively quickly because they are more active and living longer than the previous generation of THR recipients. In addition, recent improvements in surgical technique as well as in prosthesis design have made hip revision surgery a less risky procedure than it was even a decade ago. One Scottish surgeon has reported performing as many as four hip revisions on selected patients, with highly successful outcomes. According to one estimate, 32,000 revision total hip arthroplasties were performed in the United States in 2000.

While information on the epidemiology of both THR and hip revision surgery is limited, one study of Medicare patients in the United States who had had either THR or revision hip surgery between 1995 and 1996 was published in January 2003. The authors found that three to six times as many THRs were performed as revision surgeries. Women had higher rates of both procedures than men, and Caucasians had higher rates than African Americans. Other researchers have reported that one reason for the lower rate of hip replacement and revision procedures among African Americans is the difference in social networks. African Americans are less likely than Caucasians to know someone who has had hip surgery, and they are therefore less likely to consider it as a treatment option.

Degeneration of the joint around the prosthesis causes pain for some patients who have undergone hip replacement (A). To repair it, an incision is made in the hip and the old prosthesis is removed (B). Bone grafts may be planted in the hip, and a new prosthesis is attached (C). (Illustration by GGS Inc.)
Degeneration of the joint around the prosthesis causes pain for some patients who have undergone hip replacement (A). To repair it, an incision is made in the hip and the old prosthesis is removed (B). Bone grafts may be planted in the hip, and a new prosthesis is attached (C). (
Illustration by GGS Inc.
)

Description

Hip revision surgery is hard to describe in general terms because the procedure depends on a set of factors unique to each patient. These factors include the condition of the patient's hip and leg bones; the type of prosthesis originally used; whether the original prosthesis was cemented or held in place without cement; and the patient's age and overall health. Unlike standard THR, however, hip revision surgery is a much longer and more complicated procedure. It is not unusual for a hip revision operation to take five to eight hours.

The most critical factor affecting the length of the operation and some of the specific steps in hip revision surgery is the condition of the bone tissue in the femur. As of 2003, defects in the bone are classified in four stages as follows:

The first stage in all hip revision surgery is the removal of the old prosthesis. The part attached to the acetabulum is removed first. The hip socket is cleaned and filled with morselized bone, which is bone in particle form. The new shell and liner are then pressed into the acetabulum.

Revision of the femoral component is the most complicated part of hip revision surgery. If the first prosthesis was held in place by pressure rather than cement, the surgeon usually cuts the top of the femur into several pieces to remove the implant. This cutting apart of the bone is known as osteotomy. The segments of bone are cleaned and the new femoral implant is pressed or cemented in place. If the patient's bone has been classified as Type IV, bone grafts may be added to strengthen the femur. These grafts consist of morselized bone from a donor (allograft bone) that is packed into the empty canal inside the femur. This technique is called impaction grafting. The segments of the femur are then reassembled around the new implant and bone grafts, and held in place with surgical wire.

A newer technique that was originally designed to help surgeons remove old cement from prostheses that were cemented in place can sometimes be used instead of osteotomy. This method involves the use of a ballistic chisel powered by controlled bursts of pressurized nitrogen. The ballistic chisel is used most often to break up pieces of cement from a cemented prosthesis, but it can also be used to loosen a prosthesis that was held in place only by tightness of fit. In addition to avoiding the need for an osteotomy, the ballistic chisel takes much less time. The surgeon uses an arthroscope in order to view the progress of the chisel while he or she is working inside the femur itself.

After all the cement has been removed from the inner canal of the femur, the surgeon washes out the canal with saline solution, inserts morselized bone if necessary, and implants the new femoral component of the prosthesis. After both parts of the prosthesis have been checked for correct positioning, the head of the femoral component is fitted into the new acetabular component and the incision is closed.

Diagnosis/Preparation

Diagnosis

In most cases, increasing pain, greater difficulty in placing weight on the hip, and loss of mobility in the hip joint are early indications that revision surgery is necessary. The location of the pain may point to the part of the prosthesis that has been affected by osteolysis. The pain is felt in both the hip area and the thigh when both parts of the prosthesis have become loose; if only the femoral component has been affected, the patient usually feels pain only in the thigh. As was mentioned earlier, however, some patients do not experience any discomfort even though their prosthesis is loosening or wearing against surrounding structures. In addition, a minority of patients who have had THR have always had pain from their artificial joints, and these patients may not consider their discomfort new or significant.

In general, diagnostic imaging that shows bone loss, loosening of the prosthesis, or wearing away of the joint tissues is an essential aspect of hip revision surgery—many orthopedic surgeons will not consider the procedure unless the x-ray studies reveal one or more of these signs. X-ray studies are also used to diagnose fractures of the hip or dislocated prostheses. In some cases, the doctor may order a computed tomography (CT) scan to confirm the extent and location of suspected osteolysis; recent research indicates that CT scans can detect bone loss around a hip prosthesis at earlier stages than radiography.

Infections related to a hip prosthesis are a potentially serious matter. Estimated rates of infection following THR range between one in 300 operations and one in 100. Infections can develop at any time following THR, ranging from the immediate postoperative period to 10 or more years later. The symptoms of superficial infections include swelling, pain, and redness in the skin around the incision, but are usually treatable with antibiotics . With deep infections, antibiotics may not work and the new joint is likely to require revision surgery. One American specialist has said that the chances of salvaging an infected prosthesis are only 50/50.


Preoperative preparation

Certain health conditions or disorders are considered contraindications for hip revision surgery. These include:

Patients who are considered appropriate candidates for hip revision surgery are asked to come to the hospital about a week before the operation. X rays and other diagnostic images of the hip are reviewed in order to select the new prosthesis. This review is called templating because the diagnostic images serve as a template for the new implant. The surgeon will also decide whether special procedures or instruments will be needed to remove the old prosthesis.


Aftercare

Aftercare for hip revision surgery is essentially the same as for hip replacement surgery. The major difference is that some patients with very weak bones are asked to use canes or walkers all the time following revision surgery rather than trying to walk without assistive devices.


Risks

Risk factors

Factors that lower a patient's chances for a good outcome from hip revision surgery include the following:

Specific risks of hip revision surgery

Risks following hip revision surgery are similar to those following hip replacement surgery, including deep venous thrombosis and infection. The length of the patient's leg, however, is more likely to be affected following revision surgery. Dislocation is considerably more common because the tissues surrounding the bone are weaker as well as the bone itself usually being more fragile. One group of researchers found that the long-term rate of dislocation following revision surgery may be as high as 7.4%.

Normal results

In general, hip revision surgery has less favorable outcomes than first-time replacement surgery. The greater length and complexity of the procedure often require a longer hospital stay as well as a longer period of recovery at home . The range of motion in the new joint is usually smaller than in the first prosthesis, and the patient may experience greater long-term discomfort. In addition, the new prosthesis is not expected to last as long. The life expectancy of implants used in first-time hip replacement surgery is usually given as 10–15 years, whereas revision implants may need to be removed after eight to 10 years.


Morbidity and mortality rates

There are relatively few analyses of mortality and morbidity following hip revision surgery in comparison to studies of complications following THR. One study published in 2003 reported the following figures for complications following hip revision surgeries (after 90 days) performed in the United States:

Alternatives

Nonsurgical alternatives

In some cases medications can be used to control the patient's pain, or the patient may prefer to use assistive devices rather than undergo revision surgery. If infection is present, however, surgery is necessary in order to remove the old prosthesis and any areas of surrounding bone that may be infected.


Alternative and complementary treatments

Alternative and complementary approaches that have been shown to control discomfort after hip revision surgery include mindfulness meditation, biofeedback, acupuncture, and relaxation techniques. Music therapy, humor therapy, and aromatherapy are helpful to some patients in maintaining a positive mental attitude and relieving emotional stress before surgery or during recovery at home.

See also .

Resources

books

Pelletier, Kenneth R., MD. "CAM Therapies for Specific Conditions." In The Best Alternative Medicine , Part II. New York: Simon & Schuster, 2002.

Silber, Irwin. A Patient's Guide to Knee and Hip Replacement: Everything You Need to Know. New York: Simon & Schuster, 1999.

Trahair, Richard. All About Hip Replacement: A Patient's Guide. Melbourne, Oxford, and New York: Oxford University Press, 1998.


periodicals

Alberton, G. M., W. A. High, and B. F. Morrey. "Dislocation After Revision Total Hip Arthroplasty: An Analysis of Risk Factors and Treatment Options." Journal of Bone and Joint Surgery, American Volume 84-A (October 2002): 1788–1792.

Blake, V. A., J. P. Allegrante, L. Robbins, et al. "Racial Differences in Social Network Experience and Perceptions of Benefit of Arthritis Treatments Among New York City Medicare Beneficiaries with Self-Reported Hip and Knee Pain." Arthritis and Rheumatism 47 (August 15, 2002): 366–371.

Drake, C., M. Ace, and G. E. Maale. "Revision Total Hip Arthroplasty." AORN Journal 76 (September 2002): 414–417, 419–427.

Mahomed, N. N., J. A. Barrett, J. N. Katz, et al. "Rates and Outcomes of Primary and Revision Total Hip Replacement in the United States Medicare Population." Journal of Bone and Joint Surgery, American Volume 85-A (January 2003): 27–32.

Nelissen, R. G., E. R. Valstar, R. G. Poll, et al. "Factors Associated with Excessive Migration in Bone Impaction Hip Revision Surgery: A Radiostereometric Analysis Study." Journal of Arthroplasty 17 (October 2002): 826–833.

Puri, L., R. L. Wixson, S. H. Stern, et al. "Use of Helical Computed Tomography for the Assessment of Acetabular Osteolysis After Total Hip Arthroplasty." Journal of Bone and Joint Surgery, American Volume 84-A (April 2002): 609–614.


organizations

American Academy of Orthopaedic Surgeons (AAOS). 6300 North River Road, Rosemont, IL 60018. (847) 823-7186 or (800) 346-AAOS. http://www.aaos.org .

American Physical Therapy Association (APTA). 1111 North Fairfax Street, Alexandria, VA 22314. (703)684-APTA or (800) 999-2782. http://www.apta.org .

National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226. TTY: (866) 464-3615. Fax: (866) 464-3616. http://www.nccam.nih.gov. .

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. National Institutes of Health, 1 AMS Circle, Bethesda, MD 20892. (301) 495-4484. TTY: (301) 565-2966. http://www.niams.nih.gov .

Rush Arthritis and Orthopedics Institute. 1725 West Harrison Street, Suite 1055, Chicago, IL 60612. (312) 563-2420. http://www.rush.edu .


other

Hip Universe. June 15, 2003 [cited July 1, 2003]. http://www.hipuniverse.homestead.com .

Questions and Answers About Hip Replacement. Bethesda, MD: National Institutes of Health, 2001. NIH Publication No. 01-4907.


Rebecca Frey, Ph.D.

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


Hip revision surgery is performed by an orthopedic surgeon, who is an MD and who has received advanced training in surgical treatment of disorders of the musculoskeletal system. As of 2002, qualification for this specialty in the United States requires a minimum of five years of training after medical school. Most orthopedic surgeons who perform joint replacements and revision surgery have had additional specialized training in these specific procedures. It is a good idea to find out how many hip revisions the surgeon performs each year; those who perform 200 or more have had more opportunities to refine their technique.

In many cases, hip revision surgery is done by the surgeon who performed the first replacement operation. Some surgeons, however, refer patients to colleagues who specialize in hip revision procedures.

Hip revision surgery can be performed in a general hospital with a department of orthopedic surgery , but is also performed in specialized clinics or institutes for joint disorders.

QUESTIONS TO ASK THE DOCTOR




User Contributions:

1
Merianne
Thank you for a VERY informative and general review regarding hip revision surgery. You really cover the basics well and have aided me in considering the consequences of said procedure.

Much appreciation for excellent research on this topic!
2
pam
This is the clearest and most concise article I have read about total hip revision. With this knowledge I now can make an informed decision regarding hip revision surgery I may have to consider.
3
bharat
Really i am happy to read this article, my doctor has adviced total hip revision, i am done total hip relacement by hybrid method 4 years before,getting mild pain now, able to walk with stick since 4 years.
4
Joy
I've been told I need hip revision surgery. Had total hip replacement surgery in 1996. I have very good range of motion, but lately have had pain in my hip and down the thigh. Dr. said early signs of osteolist(sp?). Am very frightened to have this revision surgery as I've read that the outcome is not as good and it's a longer recovery and you might have to use a cane. I'm very active and go out a lot and am not looking forward to this at all. I'm 67 yrs old.
5
Mitra Lujan
I have had 2 hip revisions. 3 replacements in all. I know have had 3 dislocations since October 2007. I don't have pain, but the last dislocation was just too easy. Does it look like I will need another? I am 59. I have Lupus. Can I avoid a revision? How many revisions can a person get? I do have wire wrapped around thr femure. Thanks for any time you can give me. Mitra Lujan
6
joe hixon
I have ostemyelitis of the right hip after hip surgery (which was done in 1998-the hip was the wrong size and came out the side of my leg and infection started appearing in 1994) I am looking for a Veterans hospital capable of performing a hip revision with antibiotic IV drips. I live in Florida. I was told by the local va clinic that I would have to stay in the hospital up to six months!! Is this correct!?!? Would appreciate any answers from a VA doctor. Thanks, Joe
7
Tom
Doctor, Thank you very much for the very informative article. I am a 36yrs male with a THR back in 1995. I currently have occasional pain. My doc is reccomending a revision. Considering a revision's life span and my age, it looks like I may need a revision every 8-10 yrs? Very scary... I guess I'll work on more pool laps and hold off on the revision as much as I can. Thank you again for writing up this article.
8
Craig
I'm 47 now and had my hip done in 1992. I am a plumber and started having pain about 2 years ago and it has become major pain now. This article sure makes me want to wait but maybe waiting may do more damage. I do not have a Dr. in mind and would like to find a good one. I live in Colorado and just wonder if anybody has a good suggestion? Thanks for this article it was the most informative I've read.
9
Barbara
Since having a metal-on-metal THR in 2008, I have a cyst the size of a grapefruit, not infected, at the site of surgery. Despite being drained twice, the cyst returns and grows. I can find no research materials on possible causes found, e.g. rent in muscle, allergy to chromium, cobalt or titanium. Any input welcome.
Outstanding ,super-informative article ! The lay public needs access to more information like this so they can be more informed an interact with physician-surgeon more intelligently.
really helpful site best I have read to under stand revision procedure.
In 2006 I had total right hip replacement. I have suffered with pain and o ther problems..Recent xray came up with the impression: mild diffuse activity surrounding the femoral component of the right hip prosthesis.other wording with ending with this pattern suggest loosening. I've been told i probably need a right hip revision..I am seeking a successful orthopedic surgeon, preferably in Nj or Pa. who has a good reputation in doing hip revisions. Can you be of help. thanks in advance, for any help you can provide.
In 2006 I had total right hip replacement. I have suffered with pain and o ther problems..Recent xray came up with the impression: mild diffuse activity surrounding the femoral component of the right hip prosthesis.other wording with ending with this pattern suggest loosening. I've been told i probably need a right hip revision..I am seeking a successful orthopedic surgeon, preferably in Nj or Pa. who has a good reputation in doing hip revisions. Can you be of help. thanks in advance, for any help you can provide.
Thank you for such valuable information. I am a 46 year old male and due to osteoarthritis, I have had both of my hips replaced. My left hip is 11 years old and my right hip is 9 years old. My right hip started squeaking about 28 months ago and honestly, I don't have an issue with squeaking. About 4 months ago it started snapping and popping. That alone doesn't offer a lot of pain but it has changed my gait which is putting pressure on my lower back. I'm scheduled for hip revision surgery in 11 days and after reading the information available on your website, I have confidence I am doing the right thing, with the right surgeon, in the right facility. Let's face it, those of us that draw the cruddy orthopedic card have to face decisions like this and without knowledge, these decisions can be trying. Again, thank you for your help. C. Gauss
This is the most helpful information I have found. I've had the misfortune of having seven hip replacements/revisions, two on my right hip, five on my left hip, within the past fifteen months. Right now I'm in a skilled nursing facility for three months following the latest revision, which is a temporary (a spacer), needed because of infection. It is daunting to read that successive revisions may be less effective than the original replacement, but there is no other alternative if I want to walk again. I'm just hoping that the upcoming eighth replacement will resolve everything.
I plan on calling myself Octo Hip.

If there is anyone out there in cyberspace who has had anything like my experience with hip replacements and is willing to talk about it, please contact me.
Excellent article in easily understood language! I'm considering revision hip surgery due to the DePuy recall of the implant I received in Nov. 2008. Have been on crutches with severe pain 24/7 and need help to move from existing to living again.
Sincerely,
sandra orton
If anyone needs a hip revision procedure, I have found an angel in this field. His name is Dr. Delanois at Sinai Hospital in Baltimore Md. He did a revision on my hip in April 2010 and I am recovering for about 6 months now and I know I will walk again pain free. He is wonderful and very meticulous, a perfectionist. The pain of the procedure was less than my original surgery because the original hip was never right. It was very worth it. God Bless all that have to go through this, but if you have Dr. D, you'll have the best (my opinion)
Saw my Orthopedic doctor yesterday. He does not advise replacement as I have too many other health problems. Besides, I am 82 yrs. old. Had both hips replaced over 23 yrs. ago. He xrayed them. They are loose, he said.
I have been using a walker for the past three years as my hips hurt otherwise. Doc suggested I lose weight (as I am 215 lbs and only 5'2)but the reason I gained so much weight in the past year or two is because I cannot walk around without pain. I am on oxygen 24/7 and had a pacemaker put in three years ago. Just wanted to add my comments and thanks for the great article.
I had my hip replacement when I was 38 years old after an accident.
I have already had 4 hip revision operations. Currently the socket is worn,loose and painful.
The short stem in the femur was semented in 5 years ago. Is it advisable to replace both the socket and the stem at this stage ?

Previously only stems were replaced because the socket was still firmly in place and did not show too much wear 5 years ago.

I thank you.
André Labuschagne ( 61 year old, male)
20
Owen
My mother is ill. I have a translation to do about hip surgery. Your very clear article has enabled me to distract her attention from her own condition by allowing us to discuss my translation in the light of her hip-replaced friends. Thank you!
I had a Depuy Pinnacle and Corail system put in 8/09 when I was 49. It began to ache after 11 months. I have waited til now to have revision, scheduled for Jan 18th in Colorado. Originally my hip was replaced in Austin. As I am hoping to golf again and ski, what must I be concerned with. Currently I am in a lot of pain and feel surgery is only hope. I recovered quickly from surgery and swam, skiied and golfed until the loosening of stem became too painful.
Any advise would be appreciated! My original surgeon was Heinrich and revision is planned to be with Kindsfater here in Northern Colorado.
22
richard
I am recovering form my first and hopefully last revision. My first THR was recalled (made by Toyota) because the bone did not grow in to receiver. During the operation the Dr. discovered metal pieces in the surrounding tissues, apparently another benefit from a defective product. Do your homework and research what devise your doctor is recommending! Believe it or not there are a number of devises that do not have a good track record (so to speak). Ask the tough questions like is this the best devise on the market; why is this the best fix for problem? Remember (not necessarily true in all cases) that drug companies and medical manufactures have much to say about what devise the doctors have at their availability. Finally keep off the dam thing until the Dr. says you can begin training for the Boston marathon.
I HAD A REVIOSN AFTER ABOUT 20 YEARS HIP REPLACEMENT. LAST YEAR AROUND MARCH i HAD MY REVISON DONE, AUGUST MY HIP POPS OUT, NOT ONCE BY TWICE, A WEEK APART. MY DOCTOR ON THE SECOND POP OUT PUTS ME IN A HIP BRACE, DID NOT SEE ME, WAITED 6 TO 7 WEEKS LATER, FINALLY HE SEE ME A SAYS OH THIS BRACE WOULD NOT HAVE STOP IT FROM POPING OUT, i PUT THE HIP BALL IN THE WRONG ANGLE, SO OCT I HAD ANOTHER REVSION DONE. THAT WAS 2 SURGY LAST YEAR. SEPT OF THIS YEAR I HAD A KNOT THEY TOOK OFF MY INCISION, 2 WEEKS LATER I DEVELOP A INFECTION, THEY PUT ME IN THE HOSPITAL DO SURGEY AGAIN TO GET THE INFECTION OUT, GUESS WHAT I NOW HAVE TO LIVE WITH THIS INFECTION THAT WAS CAUSE BY THEIR HOSPITAL ACCORDING TO THE CENTER FOR DISEASE, EITHER THE HARD WARE WAS DIRTY OR THE OPERATION ROOM WAS. I DEVELOP PSEUDOMONAS INFECTION.
I had a total hip replacement in May 2010 immediatley had foot and leg pain shocks numbness cramps. a 11 cenimeter graft was added that shouldnt have been how do they remove this and will it repair the nerve damage
Question

I had a Total Hip about 15 years ago. I have been very active since, and now have significant hip pain. I intend to wait and see at this point, as X-ray seem to say all is OK; however if the pain continues and future testing reveal a problem I was wondering: Why can't just the "ball and socket" be replaced rather than redoing the entire procedure?
Thanks,
Brian
I am 64 years old. I am in good health. I have had a total hip replacement for 34 years. I have a limp when I first get up out of a chair. Then it subsides somewhat. When I play golf, I walk and push a 3 wheeled golf cart. I am wondering if perhaps I may need to have only the socket replaced. The last x-ray I had several years ago did not reveal any loosening of the Prothesis itself.
27
Pat
I am realy scared. Have a recalled hip..pain since original surgery, etc. Dr. I have has done hips 20 years and revisions and said it only takes less than an hour to do!!! This article states much much longer-recovery and all he said is not the same as this article..Any help out there would helpo me..
28
George Leible
Am 75 yrs old and I know I am looking at a revision on a hip that was replaced in'85. Quite frankly I am scared to death but sometimes we do what we have to do.I was told three wks ago I need this done asap.---
29
jeff
I had a Total Hip Replacement 17yrs ago. I am very active, building is how I make a living. 6 months ago while up on a roof my hip popped out, that was a painful experience from the roof to the hospital. After the 2nd time I had Hip Revision Surgery. I had the socket lining replaced, Dr. said surgery went very well. Bone looked good the ball was tight. I was back home in a day in a half. It has been 3.5 months now and I have dislocated it 6 times. The 1st. time it hurt like heck,they got it back in ok. My DR. was very surprised it popped out. Well I am going on 6 times now, 3xs putting my shoe on, 2xs while sitting down and reaching down. 1x just sitting down and I moved to get up too fast. I have been able to get it back in myself the last 5xs. I am somewhat working now, we still need to pay rent and eat. I am 52 yrs old should I have a career change or maybe a 2nd. hip revision?
30
elean
Hip replacement 5 years ago. Trouble since the beginning with squeeking, snapping (no dislocations), pain in leg with exercise and walking. More recent dull, radiating ache in prosthesis region took me to Ortho clinic. XRays, bone scan 'not conclusive', though some question of loosening. I really want to know how to keep active - walk and carry grandkids - but protect the bone so that revision does not become necessary. I am 67, female and slender.
#29 jeff here again, Iam going on #10 for pop outs now. DR. says that the cup was installed at the wrong angle. Although it worked fine for 17 yrs. The last time it poped out i was frameing a wall. The hip poped out i went down .After some coaching and awheelbarrow too sit in the guy i was working for pops it backin for me. I dont think hes goning to call me again.Iam trying to be optimistic ;
32
Barbara
Had a revision on my right hip 2 months ago.In the articile the say that it is the same as the 1st time in my case I had a 40lb weight restriction for 6 weeks. I would recomened this because my sister had a revision and had to use a cane for 7 months and had no restiction.My 1st hip had popped out twice. The ball was to small and the angle was wrong. I could not sue so had to pay for the surgery myself
33
Marianne Khurana
I had a second hip replacement 3 years ago. Unlike the first replacement, which was perfect!! this second one has given me trouble from day 1. I am still walking with a slight limp and there is still pain. It feels like the femur and pelvis are not aligned properly; as if the joint wants to collapse "backwards", i.e. instead of the femur putting upwards pressure, it points to the back. I had a bone flow scan a month ago and the surgeon said that there is some space around the femur implant. He suggested to wait a year and see if it gets worse and if it does, do a revision and put another pin. Your story about the osteotomy I found very scary. My bone density is excellent and I am 71 years old. How successful do you think a repair might be in my case?
34
Michele
I had hip revision surgery August 2009 with no pain before or after. My biggest concern was the greater possibility of dislocation. Two days ago, Jan. 1, 2012, after lifting my leg, my hip dislocated. It was painful and waited in emergency for 5 hours to have it reset. Now that my greatest fear has been realized, I am more afraid due to I now have a much greater chance of dislocation.
35
Vicki
I had a total hip replacement done in 2008. I breezed through the surgery and had a quick recovery. Four and a half years later, I fell and knocked my prosthesis loose. This ended up in a total hip revision. I am currently 3 weeks out from surgery and doing well. I am walking free of any canes or walkers. The groin pain I was experiencing prior to the revision is gone! I would strongly recommend anyone in the position of needing a revision, to go ahead and get it done. God speed to anyone having to go through a replacement or a revision!
36
tina
hello i am having revision surgery 10th march after 2 discoations after total hip replacement 3 months ago and was wondering if anyone has had a good outcome after tis surgery, i am a 55 year old female, i live in the uk, thanks, tina
37
Janet
I had a THR april,2008. I was great until 4 months ago...I started limping more and trying to swim laps more since daily walks caused more pain. I put it off until this morning with an xray at the same clinic that did my replacement. I am now scheduled for a revision since the xray showed the cup has shifted 45 degrees and now it makes sense that I have been in alot of pain. I have alot of fear right now based on reading all of the stories. I am 56 years old,active ,gardener, but have been skidding down hill lately.
38
tina
i am still waiting to hear from anyone who has had a good outcome after hip revision surgery following problems with there origional total hip replacement,i had my right hip total replacement 3 months ago and had 2 discolations in a matter of 6 weeks which are excuricating to go through and needed to go theatre to get them reduced both times so am now due mfor a revision op on 10th march and am very scared in case of discolation before this date, my exrays showed that the cup is open so is at high risk to discolate hence them doing a revision op,i just hope it will sort me out for good as i just want to get on with my life,sorry to go about myself for so long but am really concerned, thanks everyone for listening, good luck, tina x
39
catherine wilson
Informative article...I had hip replacement in 1984, a revision in 1998. Both surgeries/post op went well. In 2007, having severe pain I had total revision done. I started having thigh pain in 2009 and after several months the Dr. said the stem was loose. I had another revision in June 2010, and 18 months later I am again experiencing severe pain. Dr. believes that the head of implant has shifted and wants to see me every 3 month for xray. After 4 surgeries, I am scared that another will not last. I am 70 yrs old, in good health, and have not had any post op issues during rehab period. Any suggestions would be appreciated.
40
Sue
I had my first hip done in 1999, my other hip in 2005. No problems until 11-2011, when I fell on ice at a very. Ad angle and partially dislocated my older joint. It has now "popped" twice and am facing revision surgery to,prevent the problem. However, in reading above, I am worried that the revision will not solve the dislocations. Has anyone found a surgeon ,that can help? I have been in a hip brace for 8 continuous weeks. 3 weeks later hip popped, now back in brace. Any advice would be appreciated. By the way, I just turned 60 and up to recently was quite active. Now afraid I will not ever get my life back.
41
Marian Baggett
I had a total hip replacement in 1976. I was 26 years old. I've had very good results with the hip. I've never been back to the doctor with it until 2 years ago. I thought it need to be at least looked at after long. The leg is getting a little shorter and I use a cane if I'm going shopping or doing alot of walking. I can do just about anything I want to do. Doctor said he would not replace it if I was not in pain.
42
LESLEY
I am one of the lucky people that has had a metal on metal hip and am due a revision in a weeks time. the surgeon told me that i could have infection in the joint and if so will have my hip opened antibiotics put in and then will have to wait 8-12 wks for the second part. I am 55 yr old female had op 2008 and have been telling the consultants that something is wrong for ages and only the last 6 months have they actually admitted yes there is. I am dreading this op and am worried sick that I have an infection. i want to go back to work and get my life back and am praying that everything will be straight forward. Anyone else due a revision in the near future would bwe good to swap notes with someone.
43
Phil Erby
I had both hips replaced in 1989 with bipolar HA non cemented type as part of a 1000 hip study by the manufacturer. I will be 65 in a few weeks and going on medicare. My surgeon checked me out 2 years ago, said all looks well, but has since retired. I have been experiencing pain in my left hip for the last few weeks in the outer tissue, some times it feels like being stuck from the inside out with a needle,but most of the time just aches. I'm concerned that plastic particles from the bearing may be the cause and I might need to get them replaced. Can the bearings be upgraded to say ceramic and will that work in a bipolar? I have not had any movement with the ss ball and still have my stock sockets altho one had to be reamed from damage from the necrosis damaged ball. Could you recommend a colorado surgeon with experience in revision of this type? Dr Philip Lindberg was my former surgeon. Thanks for taking the time to build this site, very informative.
44
juliet
I had a metal on metal resurfacing in 2002. I had a large pseudo tumour from 2008 to 2012. It gave me no pain and the hip worked perfectly, but having had the tumour drained twice and it kept coming back the advice was to remove the prosthesis and replace with Ceramic on polyethelene.
This was done on 5 December, just 2 months after a had THR of the same materials on the other side.
Progress is excruciatingly slow. Bending and lifting a real problem, though no-on e told me I shouldn't do either. Pain in left groin and both thighs. I used to walk 16ks once a week, now I can just about do 3. If I had known, I would never have had the revision, but would have taken the risk with the metal hip which had served me so well for 9 years. I am 60.
45
fran
I have had THR on right side at age 60 and on left side at age 65. The right side has dislocated twice, once because of a fall. I was told that the lining of the right socket is wearing, and that a
revision is necessary. After reading all the horror stories, I am extremely wary of this operation. I particularly worry about the possibility of greater chance of dislocation after revision surgery. I would like to hear about some positive experiences. I am researching orthopedic surgeons with a hip revision specialty in Southern California, and I would appreciate any recommendations.
46
SONDRA HAMMER
I DISLOCATED MY HIP REPLACEMENT THREE YEARS AFTER SURGERY. TWO YEARS AGO HAD REVISION SURGERY WHEREIN DR. REPLACED LINER. AFTER TWO YEARS I AM STILL WALKING WITH CANE. MY ABDUCTOR MUSCLE IS CONSTRAINED, AND I WALK WITH A LIMP. I HAVE PAIN IN MY GROIN AND PAIN IN HIP RADIATING DOWN TO MY KNEE AND ALSO HAVE SEVERE NERVE DAMAGE. BEEN THROUGH EXTENSIVE P.T. WHICH HELPED SOME WHAT. DO YOU HAVE ANY SUGGESTIONS WHAT I SHOULD DO NEXT.
47
Susan
I had Metal on Metal hip replacement surgery Nov 2007 and May 2008. In 2010 started having groin and hip pain radiating down my leg. After having xray and MRI scans it showed large fluid pockets around each hip and my Ion levels were high. July 2011 I had my left hip revision surgery and January 2012 my right hip revision. I now have ceramic it has been a long and difficult journey but slowly getting my life back the muscles are slowly building up. I still get some pain when lying on side and try to lift my leg. My surgeon has been fantastic and I have so much faith in him.
48
Larry Moore
Due to dislocations I had revision surgery at which time they discovered unknown matter in the joint, which at first they thought might be infection or metal on metal inflammation. They relined the cup with plastic that had a raised lip to help prevent dislocations. 2 years and 4 dislocations later, I just had a 2nd revision and again more of this unknown matter was there. Cultures were taken and I'm waiting for results, but the Dr's say they may never have an answer. Has anyone else experienced this???Thanks for any info..Larry
49
Lesley
i HAD A THR MOM WITH A LARGE BALL 2008 AND HAD NOTHING BUT PROBLEMS. KEPT TELLING MY DOCTOR AND SURGEON SOMETHING WASNT RIGHT. EVENTUALLY THEY LISTENED TO ME AND I WAS SENT TO A REVISION SURGEON. HAD SURGERY APRIL 2ND,WOKE UP IN HDU, WAS IN HOSPITAL 18 DAYS,HAD 2 PINTS OF BLOOD AND HAD A CEMENT ANTIBIOTIC SPACER IN MY HIP. TURNS OUT I WAS FULL OF METAL DEBRIS AND A LOAD OF GREEN FLUID CAME OUT OF ME. AFTER 14 DAYS OF 3HRS OF INTERVENOUS ANTIBIOTICS I WAS ALLOWED TO GO HOME.WAS SENT HOME WITH MORE ORAL ANTIBIOTICS. I HAVE NOW BEEN HOME 5 MONTHS WITH THIS CEMENT BLOCK IN ME, I CANT WEIGHT BEAR SO I AM ON CRUTCHES UNTIL THE 2ND STAGE OP WHICH I AM HOPING IS IN 3 WKS. MY SHOULDERS, ARMS AND WRISTS ARE IN AGONY DUE TO THE CONSTANT USE OF CRUTCHES. YOU HAVE SURGERY IN FAITH THAT WHAT IS BEING PUT IN YOU IS SAFE BUT HAVE NOW FOUND OUT OTHERWISE. METAL ON METAL SEEMS TO BE CAUSING NO END OF PROBLEMS. ANYONE ELSE BEEN IN THIS SITUATION?
After my original hip joint replacement, the hip dislodged while lying in my bed and I had revision surgery using DePuy hardware which consists of an extended plastic piece that fits over the ball and is held in place by a hard metal ring. Since the initial revision surgery I've had three dislodgements all of which occurred during times when there was no stress on the joint. I have not fallen and did not engage in heavy work activities that could abnormally stress the joint.

Each of the revision failures resulted in the retaining ringl being broken in one spot. I asked for the rings so I could examine them myself. They are made of extremely hard metal and it was very difficult to spread the rings to open the cracks which did not appear to be flaws as they were uneven. The surgeon and DuPuy indicated that they have never experienced this problem. I've sent one of the rings to DuPuy for investigation.

Although my surgeon said that I broke the retaining ring that resulted in the revision joint failure, I have my doubts because of the high tensile strength of the ring. If any part of my body actually broke the ring, I believe there would be significant damage or trauma to my bones or tissue that would come in contact with the ring.

The one possibility that I somehow caused the ring to break is the fact that the surgeon noticed a large amount of fluid that poured out of the joint area after the incisions. She had the fluid analyzed and the was no infection or other unusual contents. This begs the question, could the fluid collecting in the joint result in enough pressure to force the plastic liner to break the ring, eject the ball from the socket and result in dislodgement?

Then, I learned that it takes a surgeon who has handled multiple revision surgery failures to properly install the hardware which prevents excessive torque that would force the hardware to come out and break the ring in the process. Although my surgeon has performed hip replacement surgery hundreds of times because she specializes in hip and knee orthopedics, she may not have experience with repeated revision failures of this kind.

Fortunately, I have been given the names of three physicians here in Hawaii who may be able address my issues.
51
salma
question.
Can internal implant be remove just a year after surgery?
My fracture is between neel and hip?
52
Connie
I broke my femoral head of my hip April 9, 2011. I had a Stryker "Rejuvinate" hip as my replacement. It took me 8 months of therapy 3 days a week because of all the muscle and tendon damage that occured from the incision. In early July 2012 I received a letter from my orthopeadic surgeon stating that Stryker had announced a recall due to corrosion of the prosthetic hip. I called the Dr. immediately to make an appointment to be checked out. The earliest I could be seen was Sept.6, 2012.
After an exam and xrays I was instructed to get an MRI & blood tests. The MRI showed fluid around my hip and blood work showed high amounts of cobalt. On Sept 17, 2012 the Dr. aspirated my hip joint and thick orange matter was drawn out of the joint. The "rusting" is like poison to muscles which can eventually kill the muscle of which I have been told...is not repairable.
On Sept 24, I met with another top orthopeadic surgeon who agreed a revision is mandatory.
I have been told that they have to saw the femor in half in order to remove the stem of the prosthetic hip. I am willing to travel anywhere in the US to find the BEST revision specialist. I am a 61 yr old, self-employed horse trainer and single mother of a great daughter who is a sophomore in college. This surgery has to be successful or it could force me to close my business thus not have an income.
If you know of a TOP orthopaedic surgeon who has loads of revision surgeries please pass his name and info on to me. Thank you and best of luck with your hip issues.
53
Valerie
I had a Stryker Rejuvenate implanted in 2009 and found out in July of 2012 that it had been recalled. After complaining of groin pain I was informed of this recall and was sent for an MRI. The MRI showed fluid built up around my hip. A blood test for Cobalt was not done but after reading Connie's comment I am going to insist that be done. On August 1, 2012 I had a surgical revision of my hip. With my first hip surgery I was told to be extremely careful for 6 weeks. No one told me any different after the revision. I assumed the time line was the same for the revision. At 10 weeks I did something so simple, raised my leg and rested it on the bathtub to file a toenail at which time my hip disslocated. Now after researching disslocations after hip revisions I find that they are twice as likely after a revision. I am writing this as a warning to anyone who has had a revision to be extremely careful for months after your surgery, not just weeks. My doctor did not tell me this but I certainly wish he had. Now I'm in a brace for 6 weeks and there is a good possiblility I could dislocate again.
54
Paul
I had my right hip resurfaced, Stryker metal on metal, on 12/2/08 at 47. On 1/30/13 I'm getting a THR on the same hip. The resurfaced hip never felt right. I never traumatized it but it progressively has worsened. I worked my tail off with exercise (no running) and therapy thinking I could make it better. In April, 2012, I had an x-ray which showed the femoral component is loose. An MRI showed no muscle damage. Blood work showed slightly elevated cobalt levels. The new surgeon opined the Stryker acetabular component was installed too steep. I need my mobility to work. Fortunately, the more I move, the better the hip feels. Still, it continues to get worse. Thanks for the warnings about recovery time. I'm planning to not work for 8-10 weeks, light duty for another 4 or so if work allows. I'm a self-employed electrician. To Connie, Dr. Douglas Dennis, Colorado Joint Replacement, Denver, is my surgeon. I am traveling 350 miles.
55
mike
putting in the wrong size hip stem could that fracture your femur bone.Just from walking after surgery like i was told to do.
56
bonnie
had both hips replaced within six months of each other,during 2009. Almost immediately I had thigh pain. was told it would go away, and then told it was my back. I have no pain if I do not walk a distance. However, after returning from tour in 2012, the thigh pain at both hips was intolerable. Went for second opinion. and had bone scan, showing loosening at tips of pin in femurs. Was told I need to have both hips redone. If I do not know cause, what is to say that it could happen again. Also, is there alternatives to surgery? If I do nothing, will femur start to break?
57
Harvey N
Question: can arthoscopic surgery be enployed when a revision for a recalled Stryker hip implant is required after 2 1/2 years? I have an increased cobalt levels in the blood stream and a 3CM pseudo tumor at the juncture of the modular unit.
58
Diana
2009, I had a THR. Went back to the doctor 6 months after surgery with pain and was told nothing he could do. After a 2nd opinion was told it was bursitis. After getting 2 injections with very limited results I asked my medical doctor if she had any ideas. She wrote a letter to my orthopedic doc. Then low and behold I get a letter back stating the hip, the Stryker "Rejuvinate" had been recalled. I am not sure why the original surgeon never notified me until February, 2013. I now have been tested and have been diagnosed with metal disease, high cobalt levels, pockets at the site were revealed on the MRI and am scheduled for revision in March (right away). I can not believe there is no other way to remove the old component than basically splitting the femur open and wiring it back together. I am told I can have no weight bearing for 8 weeks while this heals. I now am also concerned about dislocations as well. Is anyone out there that has had a success with this surgery? I sure would be happy to hear from you. Then again I guess if you are doing well you are probably not reading these articals anymore, right? I pray for those of you that are dealing with this. Best wishes to all.
59
Deb
My mom, age 78 is a victim of the Stryker Recall Hip...She had a new revised hip put in April 2012. Now the Drs office per Stryker is requesting blood work and MRI...The mri was done on 2/28/13 and is showing a fluid pocket, which needs to be withdrawn and tested..She has suffered severe pain for the past 5 years, since the original implant...the second revision she developed MRSA in the site and had to reoperate 2 days post op.was in hosp and rehab for 1.5 months and then on iv antibiotics 6 weeks post after discharge from the rehab. She is almost 1 year post the second hip replacement and has had subsequent pain for the past 3 months again...and now the pocket of fluid is the burning question...what is it? HELP! anyone else suffering this way?
I had a THR in Duluth Mn. on Oct. 1st. 3 weeks later I flew to my Az. home. I have had pain in my hip and groin steady since my surgery. I also have a pronounced limp which I cannot control. Last Sunday, I was sitting outside at some friends home when suddenly I had a sharp, excruciating pain in my hip. I could not move my leg without horrible pain and had no mobility. They called 911 and took me to ER. After exray they found that the ball had come out of the joint and was dislocated. The ER dr. put me to sleep and replaced it. I was told there that the prosthesis had not been implanted securely enough and it would continue to dislocate if I didn't have revision surgery. I am now in a brace to hold the hip in place and have an appt with a physician who does revision surgery. I am nervous about another surgery and also about not having surgery! I am a 75 yr. old female who was otherwise active and am not looking forward to further immobility.
Your suggestions?
I had hip revision surgery done in Nov 2012. Two weeks after the surgery I was bleeding internally. Nothing has been going right since I had the surgery I'm in so much groin pain,thigh pain, and butt pain when I am sitting, standing all day and night long. It feels like the muscles are all pulling in their. Been going to Physical Therapy since the surgery not helping. I can do all the excersises and ride my stationarty bike for 2 miles aday.It hurts like heck but everybody says keep exercising it will get better just need to strengthen the muscles.Sick of hearing this. But the main problem is I can't put any weight on the leg without having terrible pain. I am so sick of taking pills that don't help. So far they haven't found anything wrong. Does anyone have any ideas what to do next.
Had my first set of hips put in at 17 years old due to arthritis. Have had four sets on each side revised. I am now getting ready to have my fifth revision. You must, must, must use a surgeon who has had experience in revision surgery. The revisions are much more complicated. They have to put in larger balls and cups or you can dislocate easier with each revision. The best place to go is the Engh Clinic in Alexandria Virginia. They are world known for being the best in the United States.

I have never had a problem with any revision I have had and I have had two children with my replacements, travelled and held a full time job my whole life. I am 55 now, and this will be my fifth surgery on one side. My other side will have to be revised again soon. You must try and keep the muscles strong and let the scar tissue form because that holds the replacements in. But the most important thing is to use a doctor who has experience in revision surgery or you could be in trouble and setting yourself up for failure.
63
Connie
Sharon Davis: After reading all of the e-mails ( yours being the last) someone finally recommended where to go for hip revision surgery! I have a DePuy ASR prothesis which has been recalled. I have been trying to find out the best surgeons to do the revision surgery. I may have to pay to travel somewhere, but I don't care. DePuy supposedly will pay the the surgery but nothing else. I just want the best as my hip hasn't been okay since my surgery in 2009. Bummer for us all, I know. If anyone else has any suggestions on surgeons, I would appreciate that also. Again, Sharon thanks for your info; I will definitely check them out!!!
64
timothy
onr ladey in here said her hip was done in 1985 thats about 28 years love thats not bad going . i dont agree with people waiting for revisions and putting it off the plastic socket wears out causing the bone cells around the hip to die thus it loosens thats the cause of your pain . get done as soon as you can to keep as much bone as you can for the surgeon to work with . refuse a metal head and ask for a ceramic head for the socket . even ceramic on ceramic they last for ever almost . the new ceramic on metal combination bering surface also looks vary promising .i think ceramic on metal will replace metal on metal hips over time com bering was developed in leeds by dr fisher phd .its called the complete hip syestem .
65
terri
had my hip replaced in 12/2011. Immediately I began to have back pain--which I did not have before surgery. I still have groin pain. I have a BURNING pain in my back on same side as hip replacement at top of my hip in back. I now have 3 bulging discs, which I did not have pre-surgery. I have now been told I am going to need to have my hip redone and have either the ball replaced, or the ball and liner replaced. I am terrified. I've been much worse post surgery. Any help, wisdom, pointers, etc. would be greatly appreciated. I have a ceramic hip. I'm in my early 50's.
I am so glad to find this group!! I am 58 yrs old. I was born with a dislocated hip that wasn't found until I started to walk. It was operated on at 13 mo. old and over the years I did quite well with the wearing of a lift outside of my shoes. Around 35 yrs old I developed terrible arthritis and went to see a know specialist who after two yrs of babying it decided I needed a triple osteotomy. The doctor that did the surgery cut wrong and it never would unite. So I have had 26 YES 26 surgeries on this left hip. Three full replacements included. These surgeries all started in 1994. Seven years ago due to severe osteoporosis and the arthritis I had opted to try for a donor graft at Oregon Health Sciences University in Portland Oregon. The doctor there thought it would work, but when he got in to the hip he found I had zero bone left to use for grafting, so he removed the hip all together. Now I am in a wheel chair and even after a lot of PT, I still can barely stand for just minutes and the leg difference is approx. 7 inches.
Has anyone out there known anyone with these types of circumstances? I am so active in so many ways even with this ordeal. I use a scooter as it is more convenient than the bulky wheelchair. Plus I don't have a van to use my elec. wheelchair and we live outside the city limits to use dial a ride or any other assistance.
Any suggestions?
67
Walita
i have been on the computer for about an hour reading all the comments from people who had revionsurgery and i am really not very confident after listening to some of the comments since i am trying to make a decsion to surgery on my stryker recall hip it is amatter of elevated cobalt level i have a very good doctor but i am still very concered after reading all the comments i am very leary
68
carole titmuss
I had a revision hip replacement 9 weeks ago and still need to use one crutch - am in a little pain. I try to walk as much as possible. Am I doing right by using the leg often - or should I be resting it - help please.

regards Carole
69
sally jones
After 13 years, my hip replacement failed. Had a revision in April 2013. Progress slow but steady for a couple of months, but since then no improvement at all. Five months after the op, I still have a good deal of pain in and immediately under the buttock. I've twice seen the surgeon and asked repeatedly when/if I can expect any improvement, but he dodged the question and fobbed me off. Other medics refer me back to the surgeon - impasse! Has something gone wrong with the op? If so what? Should I be more patient, or is it time to rattle a few cages? My other hip is due for replacement in 6 weeks, but I doubt that will be possible if things get no better. I'm 65, a keen gardener and dog-walker, so the prospect of permanent pain/disability is truly terrifying.
I had a metal hip in 2006. Problems started in 2008. I eventually had revision surgery 7 weeks ago. On NHS I have had one Physio session. I am reliant on one crutch at home and two when out. Despite daily exercise I am unable to walk unaided. From trying I have developed pain in my pelvis and back.
Will this cycle and pain ever end?
71
cliff potts
I had a hip replacement in 2007 and have now been informed because it metal on metal it is causing high deposits of cobalt ions in my blood stream and therefore will have to be replaced. any advice on what type would be used.
72
Noreen Byrne
I find this article really informative. However there doesn't seem to have been much progress made for these revision operations in the past 10 years . Isn't there a way to prevent lameness and to why does the revision prosthesis only last 8 to 10 years? Also might we have more helpful information on after care and movements habits please as I always crossed my legs while sitting but only now -after 12 years- have I been told not to. I need 2 revisions now and I'm very scared. My best wishes to you all.
👍🌹
73
ramlal
i have done total hip replacement 7 years before but nowadays pain and discomfort have present i am always worry about revision surgery
74
Walter Russell
I had both hips replaced,2/28/12 I have been in pain eve since. When ever I stand ,or walk, My legs hurt, where the new hips go into my legs. I have been to two Doctors. They say it is my back, But can not find anything. I do not think the replacement hip fit. can anyone help?
Walt
75
dorothy bteson
interesting reading. I just want more info re physiotherapy - what can I do and how much or how long. Can I go to the gym? Have had 3 hips on right and 3 on left but until the last one in march this year they were all acetabular revisions, whereas this one was a femoral stem revision with allograft due to loosening. Have no pain, but am still using 2 cutches and partial weight bearing till 12 weeks post op then i have been told to wean myself onto one crutch. I am a registered nurse and my employer wants some idea of how long i will be off work for, but i cannot give them an answer - any suggestions about time scales??
76
Cynthia
I've had 2 total hip replacements. Left side in 2005 that one has been OK so far. Right side 12-2000 but 3 months later it dislocated, Dr. fixed it. I've had pain ever since. In 7-2010 I had a different Dr. do a hip revision. Still in pain just about every day since.I let him know about the constant pain, he says he doesn't know why I should have pain cause x-ray shows that everything is in place. He cemented the cup to fit cause it was to small. I did not know this until 3 yrs. after that he told us, cause MRI shows I have fluid on my hip.Went to a 3rd. Dr for a second opinion.3rd Dr. took out the fluid,but it's back again, but recommend no surgery. But on 6-24-2014 my hip dislocated again. The Dr. that did the revision put it back in place,but said it was going to happen again, and that I would need a new total hip replacement with matching parts this time. So my questions are 1.Is it really standard procedure to use cement to make it fit. 2.Do I still use the same DR. OR LOOK FOR SOMEONE ELSE.
77
Janet Luff
My husband had a spacer put in after his hip got infecated now he has to have another spacer put in he still has a infection any one been threw thus please help
78
SK Mittal
I have undergone a hip surgey total on left hip in 1998 with Mathys Hybrid.I am now facing some problem with my lumber spine and cervical bone. My question is that Can MRI be performed to detect the problems in Lumber and cervical without any damage to the hip joint? Pl. advise
79
gerry
Are there any types of liners (such as constrained liners with metal locking ring or brands?) that seem to last longer than others?
Hi All,

Thank you for the informative post and I appreciate the knowledge.

I am 49 years old and scheduled for a revision next month. It is due to a pelvic cyst, that the original surgeon failed to address, which has grown to the point of dislodging the ball joint of the metal-on-metal implant. I have had 2 childhood pinning surgeries in the late 70s and a total hip replacement on one side in 2004, and the other side is also regarded for total replacement. If someone could offer some insight in regards to success rates, recovery time, etc.; it would be greatly appreciated. Also, my surgeon is the only surgeon in the area who has, at best,minimum experience with revision involving pelvic cyst and I am NOT reading confidence from him.
81
Donna
I fell an broke my hip in 2012 - the hip replacement I received was only the metal stem without the socket. This has caused much pain and after a second doctor's opinion, will now need a thr. Has
anyone else had this problem, I don't understand why I did not receive a complete replacement the first time. I was told this happens often, but I have not read anything at all about it.
82
jeanne Miller
I had my first Hip replacement in2001 .Another on my left leg in 2013' now the Dr. Says I need a revision surgery on my right hip. I am now 82 years old and I am r sitting another operation. I have many other health problems. What is your advice?
I had both hip's replaced in 2011,I had avascular necrosis bilateral. My ortho doc put in the Stryker Rej. so now my cobalt and chromium levels are high and I'm sched. to have my rt hip revised in April. Reading the comments I'm really scared now, I have to be back at work in 6 wks! I'm 54 yrs old, in pretty good health, little overweight. Is it possible I'll be able to go to back to work in 6 weeks? I'm an xray tech. and my job is physical, moving pt.'s, pushing portable xray machines and walking a lot. Does the femur always have to be broke, and does the cup need to be replaced as well? Is it more often than not that the legs are shortened, and is it likely I'll have to deal with dislocation? Thank you for responding in advance!
84
Melinda
I am a very active 75 year old. Fell September, 2009, and had a partial hip replacement (Depuy). Five years later, I had a hip revision. Surgery went well, but had paralytic ileus which put me back in the hospital. Was on 25% weight bearing for five weeks and at six weeks was walking without assistance. BUT, the pain has worsened and is not confined. The worst is between my knee and where I feel the prosthesis ends. I am horrified as to what is going on, with surgery almost five months out. My mind is cluttered with thoughts of another two surgeries, if there is infection, etc. I had a lot of drainage, and there were five attempts with three different wound vacs. The vac actually caused a deep superficial wound, with the scab finally coming off three months later. After reading all the above, I would suggest you do your homework before deciding on hip revision. I went on faith, and now I do not know what awaits.
Dr. Kwon at Mass General Hospital Boston Ma
I would not go to any other surgeon for Hip of Knee replacement
check him out
Good Luck
86
walita thompson
thank you for all the great comments on your rmarks I have a right hip that I am needing revision surgery and after reading all the different comments I have prayed and made up my mind to really think about making a

serious decision as this on my body iam 80 years old I am going to put a lot of thoughts and prayers into it thanking you in advance
87
Bob petersen
I had my left hip replaced Ann 6 days later stumbled and my left femur cracked.Is this common?
88
michelle Atkinson
I had a hip replacement when I was 23 years after having a car accident, due to osteoporosis. I had a revision in 1996. I fell down about 5 weeks ago, and they found that one of the three screws were broken and I have a open cup. I am walking on crutches at the moment and I am able to put more weight on my hip. Would there still be a possibility that I would have to have another revision?
i will have my 2nd hip revision in two weeks from X-rays and Mari the problem is not the hip all my pain is in my upper thigh. I had a hematoma after first revision I trust my surgern but still afraid of outcome.
I had a birmingham hip resurfacing in 2008. In December last year after a few problems i had a biopsy in my hip, the results showed bacteria growth. My consultant said i would need two stage revision surgery, the first op was 7 weeks ago and i am having pain in my lower buttock, across the front of my leg and groin. Plus i am getting severe pins and needles in my thigh. I am still using two crutches outside and one crutch indoors. i cannot walk without it. I am not happy as i thought i would be more mobile by now i am 53 and normally very active. Is this normal? has anybody else suffered the same? please email me if you are having similar problems.
I am scheduled for revision surgery on my left side August 3, 2015 and on my right side October 5, 2015. I had bilateral hip replacement, minimally invasive surgery in 2007 using the the DePuy ASR XL metal on metal implants that were recalled in 2010. The reasons for the revision surgery is the high cobalt and chromium levels in my blood. If anyone has had the revision surgery and can explain their progress and advise what their levels of Cobalt and Chromium were before the revision and if they decreased after - I would sure appreciate it. In reading the comments the revision surgery sure seems like a risk.

Thanks
92
James Haynes
My problems started around 1996 when I tripped on a cable for a taxiway at our local Naval Base. Told my supervisor & went to the Hospital on base. They put me on light duty for two weeks but, when I went back I told the Dr. that something was crunching in my right knee, he said it was nothing; two & half years later I went to a local knee surgeon, got an MRI & he said he didn’t see anything but, I insisted to have it scoped. Guess what, I had a cartilage that was torn in a “V" & flipped upside down. He repaired what he could But finally in June of 2001, I had both knee’s done at the same time - Bi-Lateral surgery. In 2006 I had my right hip replaced with a Stryker Ceramic but, over the last three years when I stand up in the shower from my shower seat & lean to my right side & go up& down it grinds. My Dr. says I don’t know what I’m talking about. My last Dr. M.W. Britt now at LSU in the medical dept. said I had chipped the porcelain in the joint but, he was leaving in two weeks & would have to wait for the new Dr. ( he stinks & doesn’t listen to the patient ). So I got diss missed with nothing. Also I’ve had 3 Total Elbows (don’t know which brand), took out C-6 out was crushed & replaced it & put a metal plate with six screws behind my throat. Lately had my back fused from L-3, L-4, L-5, S-1 & eight screws. So I only have six artificial joints. Any suggestions on how to see the ceramic is chipped MRI, CT SCAN, PET SCAN? Puzzled? Will Have to go to San Antonio or Houston if so. Corpus Christi, Tx is to small of a town & my doctor won’t listen.
93
val
I had hip revision in June 2015 after having problems with the resurfacing implants I had in 2008. Now after surgery I have had a lot of pain in groin and lower buttock, blood tests have come back with slightly elevated CRP levels which I am told are as expected. I am still using a walking aid after 12 weeks and without it I have a severe limp and discomfort. I am doing exercises as advised by my physio and walking. But things seem so slow. I expected to be back to work at about 9 weeks. Is this normal?
94
Laurie L Mumm
I have had bilateral hip replacements done in 2008, and 2011. I had to have the right one redone due to a loose cup (this was a metal-on-metal) approximately 4 years later. The biopsy taken during this surgery revealed an infection so was placed on IV antibiotics for 6 weeks. Within the past 2 years, I have developed a large amount of fluid in the upper thigh which also goes into the hip joint itself and is visibly noticeable. The leg is warm to touch but not red and I have approximately 500 mL of fluid taken out about every 6 months by my Rheumatologist to send in for C/S and cell count. All comes back negative. I have also had several other tests (Bone scan and the Indium 111 Test) to rule out any infection.

They have tried to extract the fluid from around the joint itself numerous times but the fluid is too think to extract it. So, the question remains and is stumping my doctors - what is causing this fluid accumulation? It has increased within the past several months and increases with activity. It is also painful at times. My Cobalt counts are elevated even with the metal-on-metal being replaced. Some think it's a reaction to the prosthetic parts (I have Biomet parts), perhaps the infection is within the parts itself and is not showing up (based on past history) on the tests, some type of auto-immune inflammatory disease (I do have serogeous RA and am no Methotrexate), or...what?

Any thoughts or suggestions would be greatly appreciated.
95
ugyen tshering
My hips has been joined from year 2006 and m 23 yars old
96
Relesia Faulkner
Everyone is not the same, some of us have other conditions that maybe weren't mentioned. I am a carrier of ALD, I lost my oldest son about 3 years ago with ALD, I've been a CNA since I was 19-20??, 6 year of dealing with son & his condition, I started falling & right leg would just buckle, saw my PCP & was referred to a surgeon, right hip was replaced n Oct left2014, hardest thing ever to endure, took a good 6 months of healing, July 2015, left hip surgery, did good 1st 2 wks after, a day before my 2 wk appt, my leg swole up on my, I applied ice all that nite off & on hoping it would help, next day went to see doc, bandage was removed, stitches were removed & I was told there was some swelling & a bit of drainage but not bad, doc wanted to see me back n a wk, before wk arrived I was back n doc office cuz now my leg is splitting open at the bottom half & the top half is healing, this day I saw an attending and she attempted to glue me back, before she glued me she first applied pressure to get it to drain then glued me & said that should help, by night leg opened back up, back to doc office & this time I was told I had infection & he needed to go back n & clean my leg out, I agreed,I was cut n same spot Again for second time, the head was removed & replaced & I had been debreded, A drain tube was placed n & I had a 6 day visit n hospital, 1 picc line placed n arm, therapy twice a day n Hosp, sent hm on 2 IV antibiotics, went for 2 wk check up, stitches removed & leg draining pretty bad, doc wanted to see me n another 2 wks, looks like leg Trying to heal, right at 2 wks appt, a knot forms right n my incision, painful like a boil wanted to open but could not cuz leg was closing, saw doc again & I was told leg still infected and this time he needed to go back n & take everything out & put n a cemented hip spacer, I was shocked, Sept 2015 surgery 4 days old & this spacer is no joke, back on 6 more wks of antibiotics , I was cut in same spot for a third time & one on my butt to take out the old & put n the new 😡
97
Patricia Fabricius
I had my total hip replacement in the summer of 2013. It has been just over two years and although I have other problems causing me to use a cane or walker - my hip replacement felt fine, that is, until about a month or two ago. I was VERY carefully. It hurt at first while lieing down in bed. Ironically, if I went and to lie on my right side (side of THR) it stopped hurting.
Now, it hurts erratically. I am a medical transcriptionist and as I am sitting and typing - no pain. Getting up to walk? Pain. Varying degrees. My recovery was no fun and a lot more painful that I expected from what people had told me. The thought of a revision really makes me nauseated. I am trying to work up the nerve to contact my surgeon, who by the way, I do have confidence in. Any thoughts?
I fractured my left femoral in 07/2008. DePuy Corail hip stem with a bipolar shell was used. I have been doing Ok until recently, however I have pain in the hip/butt area that travels to the thigh and left foot. I went to see an orthopedic surgeon who specializes in hip/pain area. I was told that I need a revision. I have CAD & COPD and have osteoporosis. I am not sure what to expect. I did get educated after reading the above article about hip revision. It seems that revision does not mean complete recovery. Many of the writers have various problems ever after revision. It is now 11/2015. I did not expect problems so soon. I wonder if DePuy has ever been recalled? Please advise if you can.
99
Lonnie Moore
I was hit head on by a drunk driver when I was 27 and it shoved my femur out my backside and shattered my pelvis on the left side. Dr pinned it but there was no cartilage and he did a total hip replacement a year later. That was 26 years ago and my replacement has worn clear through the plastic insert and has been metal on metal for a long time.My leg is 1 1/2 inches shorter than my good leg. So since my pelvis is steel plated together revision surgery is gonna be hard. I have lost range of movement and that's my biggest complaint. Pain is bearable but biggest thing is I can't tie my shoe on that foot. Metal levels are high and local orthopedic doctor is sending me to a specialist 2 hours away. After reading these posts I am more afraid of a dislocation. The one I have now has completey broken the through the pelvis and is up inside my pelvic cavity an inch and a half and it grew back like this, I was on crutches for about 6 weeks and back to work. But now the loss of range, pain and high metal levels in my blood dictate a revision, so in 6 weeks I'll get my revision. My first one was supposed to last 10 years. At the 10 year mark the surgeon said it's doing well you might make it to 15 or 20 years. I fooled them and got alot of mileage out of it, but sadly original surgeon that did mine has retired. With first one I was young and didn't even have rehab, but I'm older and don't heal as fast, so expecting more of a battle this time. I just need to decide what type of hip to go with. I'm very active and low weight so hopefully that will help. I hope to be cane free again, but if not if I can just walk without limping I will be happy.
100
Relesia Faulkner
After having 4 hip surgery's in 2015 on left hip and one in 2014 on right hip, I can truley say I hate I ever had it done. The scare tissue on right side hurts all the time and the right side still hasn't healed and in June of this year will be a year. I have a limp still and I still have to use a cain and I have no energy to do much of anything. All I can say is if u can avoid it, don't do it. This was and hasn't been a easy Rd to walk down. I have been sleeping on my right side for almost a year and now my shoulder is bothering me. I'm not a back sleeper and I was told not to sleep on stomach after surgery, I try to sleep on stomach but it's not comfortable at all. The pain is always
101
Pam
Hi, I had a THR in 2006 with great results from that surgery .In 2008 I had the other hip done and had pain for eight years suffering at times so bad I couldn't work . After many injections as the surgeon thought I had bursitis this year 2016 I lost my ability to walk and was in the worse pain of my life . After all this had revision done six days ago . Cup was off both my hips are metal on metal hope this works still newly done but only buttock pain now and stiffness . Why are the surgeons not listening to people saying they are in acute pain . My X-rays always showed normal as well. .
102
Jeanette Grace Watson
Thank you. l found your article very helpful, clear and informative.
103
Terry
I really like this article I have had total hip replacement 2011, 2013, 2015 hip revision 2012 I getting ready for another hip revision 2016.
104
Nadine Farrar
I had a hip replaced 1 year ago and 6 months ago I had infection in that hip so was reopened and flushed out. I now still have problems so the Dr. is going to operate again and says I may need to have the new hip removed for 3 months before I get a replacement. Can you give me info on how I cope with the 3 months without the hip?
105
Jaydip Saha
After revision THR,how long the bleeding comes from wound?
106
george
Had THR 2000 on left hip. May 2016 had revision and bone grafting on that same hip. 6 months later I had replacement on other hip. Question is have some people encountered an extra long period of recovery for revision. My revision hip still has not gained all its strength back(after 1 year). When I walk it feels strange and people notice it gives somewhat when I apply weight to it. The other hip is doing well, and much more fluid in motion than the Revision.
Appreciate all feedback.
I am having opp total hip replacement at the ortherpdic hospital uk but reading all the comments not sure I am 70 and thought oh great get the promblem fixed but all these comments not very good
108
terry bell
I had a total hip replacement in 1995 it has done great until the last year lots of pain starting to limp if i bend down cant get up without holding something,ive also noticed i use my hand to pick up my leg getting out of a car and other places.last week i had xrays done and my liners are wore out and i need to go to a ortho doctor im 59 years old and a pipefitter so ive had a hard life.after reading thisim not so sure about another revision,the main thing i worry about if my leg came out while up high or in a bad spot.dont know what to do.
I'm 2.5 years post surgery on my right Hip. I've been doing quite well and getting back to a normal lifestyle.
I've been walking without a limp, the range has been good, sleeping good, no movement restrictions and been able to train ok. I've stayed clear of long runs or soccer.
In the last week as we approach winter I've been feeling a dull pain in my right buttock (operated hip) mainly when I sit down for a long period of time or when I'm driving for more than 30 mins. This seems worse when I'm at work and sitting through multiple meetings.

Does anyone have a similar experience? Is this related to the hip operation or failed Hip resurfacing? or does it sound more muscular related?
Can someone please advise?
Thanks
110
CJ
I had a MoM hip replacement in 2011. Had issues from the get go. In 2013 I got a recall on hip. I went to the surgeon who preformed it, and told him about recall and told him about my pain. He X-ray it and said it’s fine, second opinion same thing. So My health pretty much has been declining. Come to find out anyone who has a MoM should have a heavy metal test every 3 months.
I asked my doctor if he would run the test, explained all my symptoms. I thought it’s going to come back negative I’m just loosing my mind.
Got results back and WOW! My chromium/Colbalt levels were high! I was diagnosed with Metallosis. I had almost the symptoms. I have my hip revision surgery Friday. I am looking forward to enjoying life and having some sort of peace with all this.
Had revision surgery in January 2019. I fell on my hip today Am having groin pain. Should I go to the hospital
112
sanjay
my father got hip replacement surgery in May2019 but since then he had pain and finally doctor told it needs to be done again. He is 78 years old. Please suggest
113
Lynn thayne
I had hips done 12 to 14 yes ago I have a metal to metal in one of hips but it's starting to ache if I walk to far also I have a really bad bk it feels as if it comes from the hip area then into the back also get groin and pain at side of hip when lying on it for too long does anybody else get any pain I get
I just had THR Jan of this year. 2020 - I have at least a 3/4 to 1 inch leg length discrepancy so you suggest a revision for this? I can’t walk far I get so tired - and the surgeon offered to give me a hip replacement on the left side to even me out is this something I should consider?

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