Hip replacements are durable, but they are not permanent. After fifteen or twenty years — occasionally much sooner — an implant may loosen, wear, become infected or dislocate repeatedly. When that happens, revision total replacement in Faridabad replaces the failed components.

Revision is a considerably bigger undertaking than the original operation, and it depends on one thing above all: establishing exactly why the first replacement failed. Dr. Sunil Choudhary, FRCS (Trauma & Orthopaedics), and complex revision arthroplasty is my principal subspecialty interest.

Signs a hip replacement may be failing

  • Groin or thigh pain returning after years of being comfortable
  • Pain on starting to walk that eases after a few steps — classic for a loose stem
  • A new limp, or a sense that the leg length has changed
  • The hip dislocating, repeatedly or after minor movements
  • A clicking, squeaking or grinding sensation
  • Swelling, warmth, wound discharge or fever — this needs urgent assessment for infection

Why hip replacements fail

  • Aseptic loosening — the commonest long-term cause. The bond between implant and bone fails gradually
  • Polyethylene wear and osteolysis — wear particles provoke an inflammatory response that dissolves bone around the implant. Often silent until significant bone has been lost, which is why routine follow-up X-rays matter
  • Infection — early or late, sometimes seeded from a dental, skin or urinary source
  • Recurrent dislocation — from component positioning, soft-tissue laxity or impingement
  • Periprosthetic fracture — a break in the bone around the implant, usually after a fall
  • Implant-specific failure — including problems associated with certain historic metal-on-metal bearings

How we investigate a painful hip replacement

Infection must be excluded before anything else. Revising an infected hip without treating the infection guarantees failure.

  • Blood tests — CRP and ESR as inflammatory screening
  • Hip aspiration under imaging guidance, with prolonged culture
  • Serial X-rays compared against the original post-operative films, looking for implant migration, lucent lines and osteolysis
  • CT to quantify bone loss and assess component position
  • Blood metal ion levels where a metal-on-metal bearing was used

What revision surgery involves

The failed components are removed with as little further bone loss as possible — the most technically demanding part of the operation. Bone defects are then reconstructed using structural grafts, metal augments, reconstruction cages or trabecular metal components, and longer stems are used to gain fixation in healthy bone further down the femur.

Where infection is confirmed, a two-stage revision is the standard: implant removal, an antibiotic cement spacer, several weeks of intravenous antibiotics, then reimplantation once the infection has cleared.

As a revision total hip replacement surgeon in Faridabad, I plan every case in advance from CT imaging, with the full range of revision implants available in theatre — because the extent of bone loss is often greater than the X-rays suggest.

Recovery and realistic expectations

Hospital stay is typically four to seven days. Weight-bearing may be restricted for six to twelve weeks depending on the reconstruction. Walking aids are needed for longer than after a primary replacement, and full recovery takes six to twelve months.

Revision reliably relieves pain in most patients, but function is usually a step below a well-functioning primary replacement. The aim is a stable, comfortable, durable hip.

Frequently asked questions

How long should a hip replacement last before needing revision?

Most modern implants last fifteen to twenty years or more. Earlier failure is usually due to infection, dislocation or a specific implant problem rather than ordinary wear.

My hip replacement keeps dislocating. Can that be fixed?

Yes. Recurrent dislocation is a recognised indication for revision. Depending on the cause, the solution may be repositioning components, using a larger head, or a dual-mobility or constrained liner. The key is identifying why it is dislocating rather than simply relocating it each time.

Is revision hip surgery riskier than the first operation?

Yes. It takes longer, involves more blood loss, and carries higher rates of infection, dislocation and fracture. That is why it should be done by a surgeon who performs revisions regularly, in a hospital stocked with the full revision implant range.

I had a metal-on-metal hip years ago. Should I be checked?

Yes. Some metal-on-metal designs are associated with local soft-tissue reactions and raised blood metal ions, sometimes without pain. If you had one implanted, you should be under surveillance with clinical review, blood metal ion levels and appropriate imaging.

Where is revision hip surgery performed in Faridabad?

At the Asian Institute of Medical Sciences, Sector 21A — the revision total hip replacement clinic in Faridabad, with laminar-flow theatres and the full revision implant range available.