Hip Revision Surgery in Birmingham
Specialist revision of failed hip replacements, including complex cases with bone loss, infection, instability, and periprosthetic fracture. Mr Hussain trained at ENDO-Klinik Hamburg, one of Europe's foremost centres for revision arthroplasty.
Total procedures
498 verified reviews
ENDO-Klinik Hamburg
Medically reviewed by Mr Shakir Hussain, MBBS MRCS FRCSEd (Tr & Orth), Consultant Orthopaedic Surgeon · Last reviewed: June 2026 · Next review due: June 2029
In Short
Hip revision surgery replaces one or more components of a hip replacement that has failed because of loosening, infection, dislocation, wear, or fracture. It is significantly more complex than primary hip replacement and relies on detailed pre-operative planning, specialist revision implants, and often bone grafting to rebuild a stable, pain-free hip. The operation typically takes 2 to 4 hours, most patients stay 3 to 5 nights, and full recovery usually takes 3 to 6 months. Mr Shakir Hussain performs hip revision surgery privately in Birmingham, with every package individually quoted after consultation and imaging review.
Also known as: revision hip arthroplasty, revision total hip replacement (revision THA), redo hip replacement. This page covers revision of a failed hip replacement; if you are considering a first-time replacement, see the hip replacement page.
On This Page
Overview
What Is Hip Revision Surgery?
Hip revision surgery replaces one or more components of a failed primary hip replacement. Unlike a first-time (primary) hip replacement, revision surgery must contend with the remnants of the original implant, bone loss caused by wear or infection, scar tissue from the previous operation, and the need for more complex reconstruction techniques.
Revision hip arthroplasty is significantly more demanding than primary surgery. Operations typically last longer, blood loss is greater, and the range of possible complications is wider. The outcome is heavily influenced by the experience of the surgeon and the resources available, including access to a broad implant inventory and a specialist multidisciplinary team.
Mr Hussain holds a subspecialty fellowship from ENDO-Klinik Hamburg, training directly under Professor Thorsten Gehrke and Professor Mustafa Citak, who lead one of the world's highest-volume revision arthroplasty programmes. He brings this experience to his practice at the Royal Orthopaedic Hospital Birmingham, Priory Hospital Edgbaston, and Harborne Hospital, where he manages the full spectrum of revision hip cases.
- Revision of all hip replacement components, including cup, stem, head and liner
- Management of complex bone defects with grafting and augmented implants
- Dual mobility cup reconstruction to reduce dislocation risk
- Close collaboration with specialist infection and microbiology teams
- CT-based pre-operative templating for every complex revision case
Causes of Failure
Why Do Hip Replacements Fail?
Hip replacements do not always last a lifetime. Understanding the reason for failure is essential before planning revision surgery, as each cause requires a different surgical strategy.
Aseptic Loosening
The most common cause of hip replacement failure. The bond between the implant and surrounding bone breaks down over time without any infection. This can result from initial inadequate fixation, stress shielding, or gradual bone loss (osteolysis) caused by microscopic wear particles. Patients experience progressive pain on weight-bearing and activity, confirmed by X-ray or CT imaging showing component migration or lucent lines around the implant.
Periprosthetic Joint Infection
Bacterial infection around the hip implant is a serious complication requiring urgent specialist assessment. It may present early (within weeks of primary surgery) or late (months or years later, often from a distant source such as dental work or a skin infection). Symptoms include persistent pain, swelling, warmth, wound discharge, and fever, though some infections are indolent with minimal signs. Treatment requires surgery and a prolonged course of targeted antibiotics. Depending on timing, this is managed with DAIR surgery for early infection or two-stage revision for established infection.
Instability and Dislocation
Recurrent dislocation of the hip replacement is distressing and functionally limiting. It may result from component malposition (incorrect cup or stem angle), soft tissue insufficiency around the hip, or nerve damage affecting muscle control. After the first dislocation most are managed non-surgically, but recurrent instability or a structural cause usually requires revision surgery, often with a dual mobility cup to significantly reduce the dislocation rate.
Implant Wear and Osteolysis
Bearing surface wear generates microscopic particles that trigger an inflammatory reaction in the surrounding bone (osteolysis), progressively destroying bone stock. Modern ceramic and highly cross-linked polyethylene bearings have greatly reduced this problem, but older metal-on-polyethylene or metal-on-metal implants remain susceptible. Osteolysis detected early may be managed with liner exchange alone; advanced bone loss requires augmented reconstruction.
Periprosthetic Fracture
A fracture around or below the hip implant, most commonly following a fall or low-energy injury in older patients with osteoporotic bone. Depending on the fracture pattern and implant stability, treatment ranges from fixation around the existing implant (if it remains well fixed) to full revision with a longer bypass stem. Complex fractures with bone loss or unstable implants are best managed by a revision specialist.
Unexplained Pain and Stiffness
A small proportion of patients experience persistent pain or stiffness after hip replacement without an identifiable mechanical or infective cause. This category requires thorough investigation to exclude infection, loosening, nerve injury, referred pain from the spine, and trochanteric bursitis before considering revision surgery. Revision for unexplained pain alone has a more guarded prognosis and is reserved for carefully selected cases.
Complex hip reconstruction after multiple failed procedures
Patient initially had a fall and sustained a neck of femur fracture, which was fixed with a DHS screw. The DHS failed and he received a hemiarthroplasty. He subsequently developed an infection and all implants were removed. An attempt at reconstruction elsewhere was abandoned due to complexity. He had very limited mobility and his right leg was 8 cm short. Mr Hussain reconstructed the hip using a dual mobility socket, screw fixation and proximal femoral replacement. The patient now walks with sticks at equal leg length.
The Operation
How Is Hip Revision Surgery Performed?
Every hip revision is planned individually. Pre-operative workup includes blood tests (CRP, ESR, white cell count), hip aspiration if infection is suspected, weight-bearing X-rays, and CT scanning for templating. The surgical approach takes into account the location of previous incisions, the condition of soft tissues, and the planned reconstruction. Surgery is performed under spinal or general anaesthetic, chosen with a specialist anaesthetist; our guide to spinal versus general anaesthetic explains the options.
Implant Removal and Bone Preparation
Careful explantation of all loose or infected components is performed, with the goal of preserving as much viable bone as possible. Well-fixed components in the context of isolated failure (for example, cup loosening with a well-fixed stem) may be left in place if clinically appropriate.
Membrane and granulation tissue are removed from the bone surface. Areas of osteolysis are debrided, and bone defects are classified using the Paprosky system to guide the reconstruction strategy. Bone grafting, using morselised allograft (impaction grafting) or structural allograft, is used where the defect requires biological restoration of bone stock.
In infected cases, all cement, biofilm and necrotic tissue are excised and the wound is copiously lavaged before reconstruction or spacer insertion.
Reconstruction with Revision Implants
The reconstruction uses implants specifically designed for revision surgery, with a wider range of sizes, modularity, and fixation options than primary implants.
On the femoral side, longer cementless revision stems bypass areas of bone deficiency to achieve fixation in healthy diaphyseal bone. Modular stems allow independent adjustment of length, offset and version. In cases of severe proximal femoral bone loss, a proximal femoral replacement (megaprosthesis) may be required.
On the acetabular side, revision cups with multiple screw fixation options address cavitary defects. Metal augments fill contained defects and restore the normal centre of rotation. Cages or trabecular metal constructs are used for more severe column deficiency. A dual mobility cup is routinely considered to reduce the elevated dislocation risk inherent in revision surgery. Complex socket reconstruction, including custom implants for pelvic discontinuity, is covered on the acetabular revision surgery page.
Getting Back On Your Feet
Recovery After Hip Revision Surgery
Recovery takes longer than after a primary hip replacement, and the timeline varies with the complexity of the reconstruction. Most patients follow a path like this:
- Day of surgery to day 1: standing and walking with physiotherapy support, weight-bearing as your reconstruction allows.
- Days 3 to 5: discharge home once pain is controlled, the wound is settled, and you are safe with walking aids.
- Weeks 1 to 6: progressive physiotherapy; where bone grafting needs time to incorporate, protected weight-bearing continues with crutches.
- Months 3 to 6: meaningful improvement in pain and day-to-day function for most patients.
- Months 12 to 18: maximum function is reached.
Because these are demanding reconstructions, follow-up is closer than after primary surgery, with reviews at 6 weeks, 3 months, 6 months, and 12 months, and physiotherapy support throughout.
Fees & Funding
Hip Revision Surgery Cost in Birmingham
Mr Hussain's hip revision packages at the Royal Orthopaedic Hospital cover the surgeon's fee, the anaesthetist, the revision implant system, and your hospital stay. Because no two revisions are alike, every package is quoted individually after your imaging has been reviewed, so you receive a fixed, written, all-inclusive quotation before deciding to proceed. As the private care arm of a dedicated NHS orthopaedic hospital, ROH Private Care offers some of the most competitive hip revision prices in the UK.
Treatment is covered by all major private medical insurers: Bupa, AXA, Vitality, WPA, and Aviva. Mr Hussain is fee-assured with the major insurers, and Wendy, his secretary, can guide you through authorisation; our insurance pre-authorisation guide explains the process step by step. Full details, including what each package covers, are on the fees and pricing page.
Revision Surgery in Birmingham
Why Choose Mr Hussain for Revision Surgery?
Mr Hussain holds a subspecialty fellowship from ENDO-Klinik Hamburg, one of the world's leading centres for revision arthroplasty, and has contributed 33 peer-reviewed publications to the orthopaedic literature. His practice at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, and Harborne Hospital is built on a foundation of 5,000+ procedures and a Doctify rating of 4.98 from 498 verified reviews.
Explore his revision hip and knee outcomes and learn how to read your surgeon's NJR results.
Key Takeaways
Hip Revision Surgery at a Glance
- Hip revision replaces one or more components of a failed hip replacement; the most common causes are aseptic loosening, infection, instability, wear, and periprosthetic fracture.
- Establishing why the hip failed comes first: blood tests, hip aspiration where infection is suspected, and CT-based templating shape the surgical plan.
- Specialist revision implants, including long stems, modular components, augments, and dual mobility cups, address bone loss and reduce dislocation risk.
- Recovery is slower than after primary hip replacement: meaningful improvement by 3 to 6 months, with protected weight-bearing where bone grafting is used.
- Mr Hussain's revision training comes from ENDO-Klinik Hamburg, one of the world's highest-volume centres for revision arthroplasty.
- Competitively priced self-pay packages, individually quoted after consultation and imaging review; all major private medical insurers are accepted.
Patient Questions
Frequently Asked Questions
References and further reading
- NHS. Hip replacement. nhs.uk/conditions/hip-replacement
- National Joint Registry (NJR). Annual reports and implant performance data. njrcentre.org.uk
- National Institute for Health and Care Excellence (NICE). Joint replacement (primary): hip, knee and shoulder, NG157. nice.org.uk/guidance/ng157
- Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. How long does a hip replacement last? The Lancet, 2019. thelancet.com
Medically reviewed by Mr Shakir Hussain, Consultant Orthopaedic Surgeon. Last reviewed: June 2026. Next review due: June 2029.
Ready to Discuss Your Revision Surgery?
Book a private consultation with Mr Hussain at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, or Harborne Hospital.