Revision (re do) of a total hip replacement implies changing one or both components of the artificial hip joint. 

It is needed if there is a problem with the existing artificial hip joint. The indications for revision hip surgery include

• Aseptic loosening – loss of fixation of the implant in the pelvis or thigh bone. This is a long term complication and usually presents years after primary hip surgery.

• Infection in a primary hip joint will require its removal and insertion of a new implant. Established deep infection in artificial joints is unlikely to respond to administration of antibiotics alone.  

• Recurrent dislocation - The hip is a ball and socket joint and in a small percentage of people, the ball may come out of the socket (dislocate). In a third of patients with hip dislocation, it may go on to become a recurrent problem. This implies a problem with the hip joint and revision surgery may be needed to address this.  

• Periprosthetic fracture – is fracture of the bone adjacent to the hip, commonly due to a fall or a significant injury. Usually, these are fractures involving the thigh bone, and rarely the pelvis bone. The presence of an artificial joint makes conventional fracture fixation techniques unsuitable in these situations. These fractures require changing the hip prosthesis.

• Osteolysis – is a long term problem of joint replacements whereby the wear particles generated by joint movement initiate a bone dissolving process. The dissolution of bone around the hip joint results in loss of fixation and in these situations, the hip joint has to be changed and the bone deficient areas addressed. 

Most of the discussion relating to primary hip replacement is applicable to revision hip surgery. The notable difference is that revision hip surgery is more extensive, takes longer to perform, has a higher risk of complications and a longer recovery period. The type of implant (prosthesis) used is different to primary hip surgery.

Most patients following revision hip surgery do well, although, statistically, the outcome of primary hip replacement is generally superior to revision hip surgery.