Sunshine Coast Orthopaedic Group

Procedure · Hip · Revision arthroplasty

Revision hip replacement.

Replacing some or all of a hip replacement that has worn, loosened, dislocated repeatedly or become infected. A bigger operation than the first one, and one where the planning matters more than the implant.

Call (07) 5493 8038 How it is performed
Reviewed by Professor Daevyd Rodda Orthopaedic Surgeon · MBBS, Dip. Surg Anat, FRACS, FAOrthA Last reviewed: 21 August 2026
Type
Revision arthroplasty
Complexity
Higher than primary replacement
Hospital stay
3 to 7 nights, longer if infected
Weight bearing
Sometimes restricted, plan specific
Recovery
3 to 12 months
Outcome
Generally good, less predictable than primary

What it is.

A hip replacement is a mechanical device in a biological environment, and a proportion will eventually need attention. Australian registry data reports roughly 5% revised by ten years and 10% by twenty. Revision surgery addresses that.

The common reasons a hip replacement is revised:

  • Aseptic loosening. The bond between implant and bone fails over time. Historically the most common reason.
  • Wear of the bearing surface. Particles released by wear can provoke a biological response that resorbs bone around the implant, known as osteolysis.
  • Infection. Uncommon but the most consequential, and it changes the whole plan.
  • Recurrent dislocation. Usually a problem of component position, soft tissue tension, or spinopelvic movement.
  • Periprosthetic fracture. A break in the bone around the implant, typically after a fall.

The single most important thing about revision surgery is that it is planned rather than improvised. Establishing why the hip failed comes first, because revising a loose hip that is in fact infected simply produces an infected revision.

How it is performed.

Working out why it failed

Investigation before surgery routinely includes serial radiographs, inflammatory markers in the blood, and aspiration of the joint where infection is a possibility. CT is used to assess bone stock and component position. The original operation record and the implant details matter, because knowing exactly what is in the hip determines which extraction instruments are needed.

The operation

  • Existing components are removed with as much preservation of bone as possible. This is often the most demanding part and can take longer than implanting the new hip.
  • Wear debris, granulation tissue and any infected material are cleared.
  • Bone defects are reconstructed, using augments, larger components with more surface contact, or bone graft as required.
  • New components are implanted with fixation that reaches beyond the damaged bone into solid bone.
  • Stability is assessed carefully. Larger heads, or a constrained or dual-mobility bearing, may be used where instability was the reason for revision.

Where infection is present

Infected revisions are usually staged. The first operation removes all components and cement and places an antibiotic spacer. A period of targeted intravenous and oral antibiotics follows, guided by a microbiologist. The new hip is implanted at a second operation once the infection is controlled. It is a long process, typically several months, and it is explained in full before it begins.

Recovery timeline.

Slower and less uniform than after a first hip replacement, because it depends on what was done.

  • Hospital. Usually three to seven nights, longer for staged infected revisions.
  • Weight bearing. Sometimes restricted for six weeks or more where bone graft or a fracture has been managed. Your plan is specific and will be written down.
  • Weeks 6 to 12. Progressive loading and strengthening as permitted.
  • 3 to 12 months. Continued improvement. Full benefit often takes closer to a year than the three months typical of a primary replacement.

Outcomes.

Most patients get substantial relief from revision surgery, but expectations should be set against a primary replacement rather than against a normal hip. Reported outcomes are generally good and less predictable than a first-time replacement, and the risks of infection, dislocation and further revision are all higher.

The results depend heavily on why the hip failed. Revision for wear with good remaining bone does well. Revision for infection, or for major bone loss, is a longer road with a wider range of outcomes.

Revision surgery is technically demanding and outcomes are associated with the volume of revision work a surgeon and a unit perform. Complex revision may involve colleagues within Sunshine Coast Orthopaedic Group, and Professor Rodda will say plainly if another surgeon or another centre is the better option for a particular hip.

Rehabilitation.

Rehabilitation is written specifically for your operation, because the constraints vary. The general shape:

  • Weeks 0 to 6. Weight bearing exactly as specified. Protect any reconstruction. Range within any limits set at surgery.
  • Weeks 6 to 12. Progressive loading, gait retraining, abductor strengthening.
  • Beyond 12 weeks. Endurance and function. Return to low impact activity.

Protocols via For Physiotherapists.

Questions worth asking at your consultation.

Every one of these is a fair question and none of them should be awkward to ask. Print them or bring them on your phone.

  • Am I a good candidate for revision hip replacement, and what would make me a poor one?
  • What are the alternatives, including doing nothing for now?
  • How many of these do you perform in a year?
  • What does the Australian registry say about the implant you would use for someone my age?
  • What does a realistic result look like for me specifically, and what will I still not be able to do?
  • What is your plan if it does not go well?

Frequently asked questions.

How do I know if my hip replacement needs revising?

New or increasing pain in a hip that had settled, a change in the way it feels or sounds, a limp that was not there before, or recurrent dislocation are all reasons to be assessed. Some loosening is silent and is picked up on surveillance radiographs, which is why long-term follow-up matters.

Is revision surgery more painful?

It is a bigger operation with a longer recovery, but pain in the early days is managed the same way. What differs is the length of the recovery rather than the intensity of the early pain.

Will the new hip last as long?

On average, not as long as a first replacement, because the bone is less favourable and the mechanics are more demanding. Many revisions last well for many years, and the honest answer for any individual depends on why the first one failed and how much bone remains.

What if my hip is infected?

The treatment is usually staged: remove everything, place an antibiotic spacer, treat with targeted antibiotics guided by a microbiologist, then implant a new hip once the infection is controlled. It typically takes several months and it is explained in full before it starts.

Can any surgeon do a revision?

Revision surgery is more technically demanding than primary replacement and outcomes are associated with how much of it a surgeon and unit do. Complex revisions may involve colleagues within Sunshine Coast Orthopaedic Group, and you will be told plainly if another surgeon or centre is the better option.

References.

  1. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. Adelaide: AOA.
  2. Springer BD, Fehring TK, Griffin WL, et al. Why revision total hip arthroplasty fails. Clin Orthop Relat Res. 2009;467(1):166-173.
  3. Parvizi J, Gehrke T. Definition of periprosthetic joint infection. J Arthroplasty. 2014;29(7):1331.

This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.