How do I know if my hip replacement is failing?

Symptoms of a failing hip replacement may include new or worsening pain, a sensation of instability, grinding or clicking, difficulty walking, or swelling around the hip. If you had a period of good function after your original surgery and symptoms have returned or changed, an evaluation is warranted.

How long after primary hip replacement does revision typically become necessary?

This varies widely. Some patients need revision within a few years due to infection, instability, or other early complications. Others may not need revision for 15 to 20 years or more, when wear or loosening eventually occurs. Some patients never need revision surgery.

Is revision hip replacement a bigger surgery than the first one?

Generally, yes. Revision surgery involves removing existing implants, addressing underlying problems like bone loss or infection, and reconstructing the joint with specialized components. It is typically longer and more complex than a primary hip replacement.

How long is the recovery from revision hip replacement?

Recovery is usually longer and more variable than after a primary hip replacement. Depending on the complexity of the case, full recovery may take six months to a year. Specific weight-bearing and activity restrictions depend on the surgical reconstruction performed.

Can a revised hip replacement fail again?

It is possible. Revision implants can experience the same types of failure as primary implants, including loosening, wear, infection, and instability. However, a well-performed revision by an experienced surgeon can provide many additional years of good function.

Does Dr. Zalikha revise hip replacements originally performed by other surgeons?

Yes. Dr. Zalikha regularly evaluates and revises hip replacements originally performed at other centers by other surgeons. Having access to the original surgical records and implant information is helpful for planning but not always required.

Is infection a common reason for revision?

Prosthetic joint infection is one of the most challenging reasons for revision but is not the most common. Loosening and wear remain the leading causes of revision over time. When infection is suspected, a thorough workup is essential before determining the treatment pathway.

Can revision surgery be done robotically?

Robotic-assisted technology has some applications in revision hip replacement, but its role is more limited than in primary surgery due to the variability and complexity of revision cases. Dr. Zalikha determines the best tools and approach for each individual case.

What if I need bone grafting during revision?

Bone loss is common in revision settings. Dr. Zalikha is trained in multiple techniques for managing bone deficiency, including structural and morselized bone grafting, metal augments, and specialized revision implant systems designed to accommodate bone loss.

Should I get a second opinion before revision surgery?

Given the complexity of revision hip replacement, seeking a second opinion is very reasonable and often encouraged. Dr. Zalikha welcomes patients seeking second opinions and offers both in-person and virtual consultations for this purpose.

Revision Hip Replacement Long Beach, CA

Revision Hip Replacement Surgery

Revision hip replacement is surgery to remove and replace some or all of the components of a prior hip replacement that is no longer functioning properly. It is a more complex procedure than a primary hip replacement, requiring specialized training, careful preoperative planning, and experience managing the unique challenges that revision surgery presents.

Stanford Fellowship-Trained30+ PublicationsLong Beach & Greater LAVirtual Second Opinions

Leo Zalikha, MD is a fellowship-trained orthopaedic surgeon in Long Beach, CA with specific expertise in revision hip replacement and complex hip reconstruction. His adult reconstruction fellowship at Stanford provided focused training in evaluating and managing failed hip replacements, including cases involving bone loss, instability, infection, and periprosthetic fractures.

Why Would a Hip Replacement Need to Be Revised?

Hip replacements are designed to be durable and long-lasting, but they are not permanent in every case. Reasons a revision may become necessary include:

Implant loosening:

Over time, the bond between the implant and bone can weaken, causing the component to shift and produce pain.

Wear and osteolysis:

Bearing surfaces gradually wear, and in some cases, debris from this wear triggers the body to resorb surrounding bone (osteolysis), leading to loosening or structural compromise.

Instability or recurrent dislocation:

If the hip replacement dislocates repeatedly, the components or soft tissues may need to be addressed surgically.

Periprosthetic fracture:

A fracture around or near the existing implant, often from a fall, may require revision surgery. Learn more on our Periprosthetic Fracture Care page.

Infection (prosthetic joint infection/PJI):

Infection of the hip replacement is a serious complication that often requires surgical treatment. Visit our Prosthetic Joint Infection page for detailed information.

Implant failure or fracture:

Component breakage, though rare with modern implants, may require revision.

Adverse reaction to implant materials:

Some patients develop reactions to metal debris, particularly with certain metal-on-metal implant designs.

Pain of unclear origin:

Persistent pain after hip replacement may warrant a thorough evaluation even if the cause is not immediately apparent.

Not every problem with a hip replacement requires revision surgery. Some issues can be managed nonoperatively or with less invasive procedures. The first step is always a comprehensive evaluation.

For more on evaluating a problematic hip replacement, see our Failed Hip Replacement page.

The Workup: How a Failed Hip Replacement Is Evaluated

Determining whether revision surgery is needed, and what exactly needs to be done, starts with a systematic evaluation: a focused history and physical examination, X-rays compared with prior films (with CT or specialized imaging when more detail is needed), blood tests including ESR and CRP to screen for infection, aspiration of the joint when indicated, and a review of the original operative and implant records. This workup identifies the cause of failure and shapes the surgical plan.

Read the full evaluation guide on our failed hip replacement page →

Treatment Pathways

01. Nonoperative Management

In some cases, symptoms from a hip replacement can be managed without revision surgery. Physical therapy, activity modification, injections, or observation may be appropriate if the implant is well-fixed and the symptoms are manageable.

02. Revision Surgery

When revision is indicated, the procedure involves removing the failed components, addressing the underlying problem (bone loss, infection, instability), and implanting new components designed for the revision setting.

Revision hip replacement is more complex than primary hip replacement for several reasons:

Bone loss from the original implant or from osteolysis may need to be reconstructed using bone grafts, metal augments, or specialized implant systems.
Soft tissues may be scarred or compromised from prior surgery.
Longer operative times and a more involved recovery are common.
Specialized revision implants are often required.

The specific surgical approach and plan depend entirely on the reason for revision and the patient's anatomy.

03. Staged Revision for Infection

When prosthetic joint infection is the cause of failure, a staged approach is often used: the infected implant is removed in a first surgery and a temporary antibiotic spacer is placed; after a course of intravenous antibiotics, a new implant is placed in a second surgery. In select cases, a single-stage approach or a DAIR procedure (debridement, antibiotics, and implant retention) may be appropriate. Learn more about these pathways, including one-stage versus two-stage revision, on our PJI page.

Recovery Expectations

Recovery from revision hip replacement is generally longer and more variable than recovery from a primary hip replacement. The extent of the revision, the quality of bone and soft tissue, and your overall health all play a role.

General expectations:

Hospital stay is typically one to three days, depending on the complexity of the case.
Walking with an assistive device begins on the day of surgery or the following day.
Weight-bearing restrictions may apply depending on the surgical reconstruction.
Physical therapy is an important component of recovery.
Full recovery may take several months to a year, depending on the complexity of the revision.

Dr. Zalikha provides individualized post-operative instructions and rehab protocols for every revision patient.

Risks and Complications

Revision hip replacement carries a higher risk profile than primary surgery. Potential complications include:

Infection (risk is higher in revision settings)
Dislocation or instability
Blood clots
Nerve or blood vessel injury
Fracture during surgery
Bone loss requiring additional reconstruction
Leg length discrepancy
Need for further revision surgery in the future

Dr. Zalikha discusses all relevant risks in detail during your consultation so you can make a fully informed decision.

Why Choose Dr. Zalikha for Revision Hip Replacement

Revision hip replacement requires a different level of training and preparation than primary surgery. Dr. Zalikha’s fellowship at Stanford provided focused training in complex and revision hip reconstruction, including bone loss management, infection protocols, instability treatment, and periprosthetic fracture care. He has authored over 30 peer-reviewed publications in orthopaedic surgery and arthroplasty, with research that has been cited hundreds of times.

He performs revision surgery at MemorialCare Long Beach Medical Center in Long Beach, CA and serves patients from across Los Angeles and Orange County. For patients seeking evaluation of a problematic hip replacement, he also offers virtual second opinion consultations.