Revision Hip Replacement
Sometimes hip replacements fail. There are many reasons why a hip can fail, including:
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Infection
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Fracture of the femur and /or pelvis
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Wear of either the femoral or acetabular component or sometimes both
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Loosening
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Dislocation
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Reaction to debris - e.g Metal on Metal hip replacements
Worn out hips can be painful, or may make you feel that the hip is about to dislocate. Once a hip starts to have problems, the problem often gets worse, as the loose hip can toggle around, causing bone loss.
When an old hip needs to be changed, it is called a revision. This can be of part or all of the old prosthesis. When changing the components of the hip, it is essential to get into the hip and remove it with as little damage to the patient as possible.
Many surgeons perform 10 or less revision hip operations per year.
Mr Stott is a recognised expert in revision hip surgery. He is often asked to speak nationally and internationally on revision hip surgery. He was one of the first surgeons in the UK to use a 3d printed custom hip to rebuild a patient’s pelvis after they had over 30 previous hip operations (That was over 5 years ago, and that patient has not needed further surgery). Mr Stott uses a variety of different techniques to remove and reconstruct old hips, regularly performing up to 5 revision hip surgeries per week. He is part of a team at Brighton and Sussex University Hospitals NHS Trust that receives complex referrals from Sussex, Surrey and Kent. This team includes a microbiologist and specialist radiologists.
Patients with complex problems are discussed at a Multi-Disciplinary meeting, and a plan is formed for their treatment.
Pre-operative x-ray
Post-operative x-ray
This person's right hip started dislocating several years after they had undergone a replacement elsewhere. By changing the socket, this hip was made stable and secure, and the patient had no further problems
Pre-operative x-ray
Post-operative x-ray
This patient had undergone a routine hip replacement elsewhere. Too much bone had been removed during the original surgery - weakening the pelvis. The patient had a small stumble on the ward after the surgery, and the pelvis fractured. You can see on the image on the left, the socket is tilted and has penetrated through the pelvic wall.
The patient was transferred to the care of Mr Stott who fixed the pelvis, by using a special sort of implant shown in the image on the right, and restored the patient's anatomy. The patient was able to walk on the leg immediately after this revision surgery, and was discharged home 2 days following surgery.
Revision surgery is more difficult than putting a hip replacement into a patient for the first time. This is why you should have a surgeon who performs revision hips regularly and with good results, and a hospital that is used to patients having this surgery.