The modern hip replacement has resulted in huge benefit for patients with arthritic hip disease providing them with reduction of pain, return of function and consequently an improved quality of life. The clinical success of total hip replacement is often taken for granted by the general population.
There is evidence of increased longevity (twenty years or more) with some total joint replacements, but many of these mechanical joints fail at around fifteen years when the hip joint loosens. Revision hip surgery is technically extremely difficult and few orthopaedic surgeons have extensive experience in this field. Evert Smith has performed revision hip surgery on a regular and frequent basis since 1992.
There are four approaches to the hip and access takes advantage of the muscular planes surrounding the hip joint.
- Anterior (front) Approach
- The anterior approach has been revitalised for minimally invasive surgery (MIS) — a procedure that Evert Smith specialises in that can significantly reduce recovery time — when performing a total hip replacement.
- Lateral (side) Approaches
- The anterolateral approach is the most commonly used approach for total hip replacements.
- The direct lateral approach exposes the hip joint by detaching the upper end of the thigh bone (the greater trochanter).
- Posterior (rear) Approach
- The posterior approach is the second most common approach when performing a total hip replacement.
Approaches for Revision Hip Surgery
The approaches are the same as when performing primary hip replacements but the surgical approach can be extended for increased exposure for what is a more complex procedure.
- Relief of pain and restoration of hip function
- Return to a full and active life style
- Failure of the hip implant over time
- Inherent risks of surgery
- Revision surgery is required for patients when the hip implant has failed
- Patients who are frail and have severe heart conditions
- The presence of active infection is a contraindication to hip surgery