Joint replacement · hip
Revision hip replacement
Revision surgery treats the cause of a painful, unstable, infected or damaged hip replacement and may replace one or more components.
General guidance
When it may be considered
- component loosening
- wear and instability
- periprosthetic infection
- a fracture around the implant
Individual decision
How suitability is determined
The clinical history, serial radiographs and inflammatory blood markers are reviewed, with CT or additional investigations when required. Bone loss influences both implant choice and reconstruction.
An abnormal scan alone is not an indication for surgery. The symptoms, clinical examination, progression and the patient's goals must be considered together.
Surgical plan
Decisions that tailor the procedure
- ruling out infection before a revision thought to be aseptic
- identifying which components can be retained
- classifying bone loss and preparing the required reconstruction implants
- a plan for any associated fracture, instability or pelvic discontinuity
Alternatives
What is discussed before surgery
The source of pain must be identified first. Some cases without loosening, infection or instability can be monitored and treated symptomatically; other causes require revision, sometimes in stages. A painful replacement should not be revised without a probable diagnosis.
Before the procedure
Preparation and safety
- bring the implant record, operative report and serial radiographs, if available;
- inflammatory blood tests and joint aspiration should be performed in the recommended sequence, before any antibiotics that have not been indicated;
- tell the medical team about diabetes, anticoagulant treatment, allergies, smoking and any active infection;
- do not stop or change long-term medication without instructions from the medical team;
- plan transport, help at home and any recommended assistive devices.
After the procedure
Rehabilitation
Rehabilitation is usually more gradual than after primary hip replacement and depends on the procedure performed, reconstruction stability and bone quality.
The exact protocol, permitted weight-bearing and follow-up schedule depend on the procedure performed and individual progress.
Informed consent
Risks and limitations
Risks include persistent infection, dislocation, fracture, thromboembolism, failure of the reconstruction and the need for further surgery.
No procedure can guarantee complete pain relief or a return to a particular level of activity.
After surgery
Signs that require prompt medical assessment
- fever, discharge, spreading redness or worsening pain at the wound;
- sudden swelling of the calf, chest pain or difficulty breathing;
- uncontrolled pain, new numbness, or a change in the colour or temperature of the limb.
For severe symptoms or an emergency, call 112. The instructions given to you at discharge take priority over the general information on this page.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical sources used for patient information
First step
Consultation, diagnosis and an individual treatment recommendation
This information does not replace a consultation. Surgery is recommended only after the individual benefits, alternatives and risks have been assessed.