Hip revisions are much more complex surgeries than primary (or first time) hip replacements because of the removal of the primary implant, previous scarring, loss of bone, and/or possible infection. Revision hip replacement can result in a longer hospital stay and longer surgeries with greater blood loss.
If possible, the surgeon will attempt to use the same surgical incision site used in the primary surgery. Once the implant is exposed, the surgeon will separate the thighbone component from the socket (acetabular component.) This is called dislocating the implant.
Once the implant is dislocated, the surgeon will begin the removal process. For the thighbone (femoral component) the surgeon will use special tools to remove any bone cement and/or loosen the implant from the existing bone. The surgeon must be careful not to fracture the existing bone and must leave as much bone as possible since it will help strengthen the revision implant.
Extensive bone loss may require the use of a bone graft. The bone graft may be harvested from your pelvic bones during the revision procedure, or obtained from a bone bank.
With the removal of the implant, a hollow canal is exposed in the center of the bone. The canal is cleaned by removing the remaining cement, diseased tissue or bony debris to facilitate the re-insertion of the new implant.
Next the socket or acetabular component is removed. If the component was held in place with screws, these are removed, along with any cement that may have been applied to hold the cup in place. Once the component is removed, cement and/or bone particles will be removed from the cavity. The surgeon may then make changes to the acetabular cavity such as enlarging it and/or repairing any fractured bone to allow for the insertion of the new acetabular component.
Once the component is removed, the revision surgery will continue much like the primary hip implant surgical procedure.