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Getting Hip: Recovery from a Total Hip Replacement by Sigrid Macdonald
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 Taking Care of a New Hip
REVISION SURGERY
If you have just had a hip replacement, you will want the prosthesis to last as long as possible so that you can avoid or delay a revision. Revisions are more complicated than primary joint replacements and their success rate is not as high. Revisions take much longer to perform because the surgeon has to remove the old implant, which may have been cemented in or have become infected. If the joint is infected, the infection must be treated aggressively before a new prosthesis can be inserted. Sometimes, this involves taking out the patient's hip and leaving a person without a hip for several weeks while they are on intravenous antibiotics.
The bone at the head of the femur may also have deteriorated. This is referred to as osteolysis and is a common cause of failure of the primary joint replacement. Ronald Allen, Victoria Brander and Dr. S. David Stulberg describe bone lysis as the result of the implant materials wearing out over time. This is particularly true of the plastic in the prosthesis, which can break down and create "particles that float around in the hip joint." These particles may erode the bone. M.T. Simon notes that patients with an uncemented prosthesis have a greater incidence of bone lysis five years after the surgery than those with a cemented implant. Sometimes, Richard Villar adds, the bone has degenerated so much that a bone graft is required.
Another reason why hips give out is that the implant itself becomes less secure; this is called "loosening" and is more likely to occur with a cemented prosthesis. Loosening can occur without any symptoms, which is why regular follow-up x-rays are important. Other causes of failure of the artificial joint are hip fractures, dislocations and infections.
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