Medical Q&As

Total hip replacement - can be repeated?

I am 51 years old. I was born with a congenital abnormality of the hip. I had it replaced 20 years ago and it has started to give me some problems. I am nervous about having it re-done. The hip has always given me some trouble since it was done but it has started to get worse recently. Should I see about having it done again?

Presumably you had congenital dislocation of the hip and underwent a total hip replacement twenty years ago. An artificial hip joint consists of three parts; the stem, the ball and the socket. The stem is usually made of metal and is inserted into the upper end of the thighbone. The ball is made out of highly polished metal and replaces the original head of the femur, which is cut from the femur or thighbone and removed. The ball and stem are solidly attached to each other. The socket, which is attached to the side of the pelvis, consists of a plastic lining and a metal backing. The socket and stem are attached to the pelvis and femur respectively with bone cement. Current results indicate that approximately 80% of these prostheses function well for twenty years. However, there are a number of factors that affect the durability of the prosthesis. The personís weight and level of physical activity are crucial considerations. If a person with a prosthesis gains an excessive amount of weight this could stress the artificial hip joint and could lead to mechanical failure. It is also possible to dislocate the ball from the socket if the hip is exposed to too much abduction. Although the dislocation can be reduced the stress on the prosthesis could shorten its lifespan. It is certainly possible to repeat a hip replacement and given the fact that you are 51 years old this is certainly an option to be considered in your case. This involves removal of the original prosthesis and its replacement with a new one. The success of this second procedure depends on the state of the bone into which it is to be inserted and the general condition of the muscles and other tissues around the hip joint. Assuming that the procedure went well you could be active again as speedily as you were after the first procedure twenty years ago. Your recovery need not be any more difficult despite the fact that it would be a repeat procedure.