Hip revision at Highgate Hospital

Hip replacements can fail for several reasons:

• Wearing out of the artificial ball and socket joint
• Infection in the hip joint
• Dislocation
• Fracture of the thighbone (Femur)

On the day of your hip revision

At the hospital, we’ll show you to your room where one of our Healthcare Team will meet you to explain each stage of your treatment and recovery. They’ll take notes on your general health, medical and surgical history and ask if you have any allergies. Your blood pressure, pulse and temperature will be taken and an identification band with your name and hospital number on it will be placed on your wrist.

You will be shown where the alcohol hand rub is and how you and your visitors should use it. You will also see staff members using this before they treat you; please feel free to ask us if we have washed our hands.

Your consultant will come to see you and if you haven’t signed a consent form already, you’ll be asked to sign one by your consultant. This is to confirm that you understand the details of your operation, the benefits and the risks associated with it, both during and after your operation.

When it’s time to go to the operating theatre, our ward staff will take you. There, our theatre staff will take you to the anaesthetic room. They are very reassuring – they will understand how you feel and will try to help you in every way possible.

What happens during hip revision?

A variety of anaesthetic techniques are used. Prior to your operation the anaesthetist will discuss these options with you.

During your operation your surgeon will remove your old hip prothesis and any cement that might have been used to hold it in place. He will replace your old prosthesis with new components. 

Your surgeon’s choice of prosthesis will be based on several factors such as your age, your level of activity and your current condition. Both cemented and uncemented replacements are used. If you have concerns be sure and ask your surgeon about his prosthesis choice. 

After your hip revision

Once your operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic. Your wound, blood pressure and pulse will be checked carefully. You will have a large dressing covering your wound. 

You may have a small tube coming out of your wound, this is to drain away any excess fluid from the inside of the wound. You may also have a drip (infusion) going into your arm. This will keep you hydrated until you are able to drink, and it can also be used to give you pain relief.

When you are stable and comfortable, a nurse will take you back to your room.

Back in your room

Once back in your room, our nursing team will continue to check on you to make sure you are recovering well. Try not to touch or disturb your dressings as this can introduce infection. If you notice any bleeding or have any pain, don’t hesitate to speak to one of our nurses. After you’ve recovered from any effects of the anaesthetic, you can have something to eat and drink.

While you are in bed, you may have help with the circulation in your legs, in order to prevent blood clots (DVT). The first day or so you could wear boots on your legs that are inflated with air. You will also wear support stockings to help your circulation and may have daily injections or tablets to help prevent blood clotting which may continue for up to 6 weeks. Also we may encourage you to move your legs if you are able.

You may have some deep breathing exercises to do, to help prevent any chest problems after surgery. The day after surgery you will have an X-ray of your new hip to check its position.

Don’t forget to wash your hands with soap after going to the toilet.

Going home after hip revision

A physiotherapist will give you some exercises to help get your new hip moving. These are important to help you

make a good recovery.  You may be using crutches or a walker.  When you are able to walk up and down stairs, you can go home. You won’t be able to drive, so you will need someone to come and take you home from the hospital, once you have been discharged.

It’s usual to return to see your consultant as an outpatient after your operation. You may also need to have stitches or staples removed. You’ll be given information about these appointments before you go home. We’ll also give you some pain relief medication to take with you.

When you get home you will be tired and should rest. However, it’s also important to aim to gradually increase your physical activity each day, so you should continue with the exercises the physiotherapist showed you. These will help to reduce stiffness and strengthen your legs. Keep using a walker, crutches or a walking stick until you feel confident.

To help you regain mobility, it’s recommended that you take any pain relief medication we have prescribed. Continue taking this until you are pain free.

So you don’t damage your new hip and to help your wound heal, you should follow a few restriction for the first six weeks of your recovery:

• Avoid bending your new hip beyond 90 degrees
• Avoid rolling your leg towards the other leg
• Avoid crossing your legs
• Avoid twisting on your new hip when standing
• Use the shower instead of the bath
• Keep wearing your support stockings - you may have to do so for four to six weeks

If you have any questions or concerns about your restrictions be sure and ask a member of the Healthcare Team or the Physiotherapist.

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
• Difficulty passing urine
• Chest infection
• Heart attack
• Stroke

Specific complications might include:

• Split in the femur
• Nerve damage around the hip
• Damage to the blood vessels around the hip
• Infection in the hip
• Loosening of the replacement
• Dislocation
• Leg length difference
• Death (rare)