When is revision surgery necessary?

Modern technology allows most hip replacement surgeries to last a long time (20 years or more in most cases). Some newer technologies, such as ceramic-ceramic total hips or highly crosslinked polyethylene, may extend the life of a total hip replacement even longer, particularly in younger, heavier, or more active patients. However, revision surgery may be necessary when the hip socket wears out or if the prosthesis loosens. Luckily, this happens in only 10% or less of total hip replacements.

Revision total hip surgery involves going in (generally through the original incision) and replacing the worn out parts. Sometimes, the plastic debris generated with wear of a plastic socket may cause a reaction in the bone called “osteolysis.” Osteolysis is a process where bone cells act too aggressively and eat holes in the bone. When this happens, the revision surgery may include bone grafting of the holes using either artificial bone or donor bone from a bone bank. Most revision surgeries do quite well today, although the risks of surgery are a bit higher than with first time total hip replacement.

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