Dr. Öğr. Üyesi Görkem Kıyak
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- 21+years exp.
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Joint Replacement
Revision hip replacement
Why a hip replacement may need revising (loosening, wear, infection, dislocation, fracture), how surgeons assess the cause, what partial and full revision operations involve, what the evidence says about outcomes, approximate costs in Turkey against the UK, US and Germany, recovery milestones, risks, travel limits and how to choose a revision team.
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Revision hip replacement: what it is and when it is needed
Revision hip replacement is an operation to remove, replace or adjust part or all of an earlier artificial hip. The first replacement is a very successful operation, and most last 15 to 20 years or more, but no implant lasts for ever. When the socket (cup), the stem in the thigh bone, or the bearing surface between them wears, loosens, becomes infected or fails, a surgeon may recommend revision. It is more demanding than the first operation: the surgeon must take out the old components without harming the remaining bone, rebuild any lost bone, and fix the new implant securely.
This guide explains why hips fail, how the cause is identified, what the operation involves, what the evidence says, what revision costs in Turkey compared with the UK, US and Germany, and who should think carefully before travelling. For the primary operation see our guide to total hip replacement, and for the specialty as a whole our orthopedics treatments in Turkey.
Why do hip replacements fail, and what are the signs?
- Aseptic loosening and wear: the bond between implant and bone weakens, or particles from a worn bearing trigger bone loss (osteolysis). Typical signs are pain in the groin, thigh or buttock, especially when starting to walk, and a feeling of the leg giving way.
- Infection: bacteria on the implant cause pain, swelling, warmth, a draining wound or fever, and sometimes only persistent pain. It needs urgent specialist care.
- Dislocation or instability: the ball repeatedly slips out of the socket, often because of component position, soft tissue weakness or muscle imbalance.
- Fracture around the implant: a break in the bone near the stem or cup, usually after a fall, which can loosen the implant.
- Implant-specific problems: some metal-on-metal bearings and certain stems have been associated with tissue reactions or early failure and need monitoring or replacement.
Not all pain after a hip replacement means the implant has failed. Spine problems, tendon irritation, referred pain and nerve problems can mimic it, which is why assessment comes first.
How is the cause of a painful hip replacement found?
A revision team starts with your operation notes and the implant details (brand, size and date), which you should bring or request from your original hospital. Examination checks your walking, leg length, strength and any signs of infection. Standard X-rays are compared with earlier films to see whether the implant has moved or bone has been lost; a CT scan, sometimes with metal-reduction software, shows the bone stock in more detail. Blood tests such as CRP and ESR screen for infection, and when infection is suspected a sample of joint fluid is taken for culture.
The result is a classification of the problem and a plan: whether only the bearing can be exchanged, whether the socket, the stem or both must be revised, whether bone defects need grafting, and whether infection requires a staged approach. A hospital that offers a price before it has seen this information is guessing.
What does revision hip replacement involve, step by step?
Revision is nearly always performed under spinal or general anaesthesia and takes about two to four hours, longer for complex cases. The surgeon reopens the old scar, assesses the joint and takes samples for the laboratory. The old components are carefully removed, often with special tools to protect the bone. Damaged or missing bone is rebuilt with bone graft (from a bone bank or your own), metal augments or cages. The new implants may be cemented or uncemented, and may include longer stems, larger or porous cups, constrained or dual-mobility liners to improve stability. The wound is closed over drains and you are mobilised within a day or two.
There are three broad types of operation. A partial revision replaces the liner and head only. A single-component or full revision replaces the cup, the stem or both. For infection, surgeons may remove the implant and insert a new one in one stage, or use a two-stage approach: removal and antibiotic spacer, weeks of antibiotics, then a second operation. Where bone has been lost, techniques described in our bone graft guide may be part of the reconstruction.
How well does revision hip replacement work?
Revision usually relieves pain and restores function, but the outcomes are less predictable than the first hip replacement and the revisions themselves do not last as long on average. National joint registries such as the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man report that re-revision rates are higher after revision than after primary surgery, with the highest rates after revision for infection and for instability. Results depend heavily on the cause, the amount of bone loss, your general health and the surgeon's experience with complex cases. The honest expectation is substantial improvement in most people, a higher chance of complications than the first time, and a need for realistic goals; complete return to a normal hip is not guaranteed.
Revision hip replacement cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for surgery and hospital stay, not hospital quotes, and the spread is wide because complexity varies so much. Each hospital confirms its own price in a written quote after it has reviewed your X-rays, scans and history.
| Country | Approximate cost range |
|---|---|
| Turkey | €8,000 – €25,000 |
| United Kingdom | €15,000 – €35,000 |
| United States | €35,000 – €90,000 |
| Germany | €15,000 – €35,000 |
What changes the price: a liner exchange against a full two-component revision, special implants (long stems, augments, cages, constrained liners), bone grafts, blood products, the length of stay and any intensive care, and the investigations needed beforehand. A package should list the implant, the hospital stay, physiotherapy, medication, transfers and what happens if there is a complication. Ask what the price covers if a second operation is needed.
Partial revision, full revision or staged surgery: how do they compare?
| Approach | Suited to | Typical limits |
|---|---|---|
| Liner and head exchange | Worn bearing, some dislocations, well-fixed components | Does not help a loose implant; limited when the cup is badly positioned |
| Cup, stem or both revised | Loosening, bone loss, fracture, malposition | Longer operation; more blood loss and a longer recovery |
| Two-stage revision for infection | Established deep infection | Two operations and weeks between them; not practical to split across countries |
For a hip that has not failed but simply hurts, or for a younger person considering a first operation, see our overview of joint replacement.
Who is a good candidate for revision, and who should not travel?
You may be a candidate for revision if imaging and examination show a loose, worn, unstable or broken implant and the pain limits daily life. Your general health matters as much as the hip: heart and lung disease, diabetes, anaemia, smoking and weight raise the risks and need planning. Many revisions can be scheduled; some, such as periprosthetic fracture or acute infection, are urgent and need a team that can look after you afterwards.
Travel is hard to justify if you have an active deep infection needing a two-stage plan, severe medical conditions, or no named surgeon at home who will accept follow-up. A flight soon after major hip surgery raises the risk of blood clots, so plan a longer stay and a prevention plan. A sensible first step is to send your scans and operation notes for a remote review before deciding.
Recovery after revision hip replacement: what is the timeline?
- Days 1 to 5: you stand with a physiotherapist within a day or two; most people stay in hospital four to seven days.
- Weeks 1 to 6: walking with crutches or a frame; weight-bearing may be limited if bone has been grafted or the cup is uncemented. Blood-thinning medication is used to reduce clot risk.
- Weeks 6 to 12: progress to a stick and then unaided walking, with regular physiotherapy.
- Months 3 to 12: strength and function improve; many people reach their final level only after 6 to 12 months.
Plan to stay in Turkey for about 10 to 14 days, until the wound is healing, you are mobile and the surgeon is happy for you to fly; the return needs aisle seating, regular walking and clot precautions as advised. Rehabilitation continues at home with a physiotherapist, so arrange this before you leave.
Risks and complications of revision hip surgery
Revision carries higher risks than primary replacement. They include infection, dislocation, fracture of the bone during surgery or later, blood clots in the leg or lung, nerve injury that can cause foot weakness, difference in leg length, heavy blood loss, ongoing pain and the need for further surgery. The risks rise with extensive bone loss, long operations, and in people who are frail or have other illnesses. The NHS and the British Orthopaedic Association publish patient information on hip replacement and revision, and the registry data mentioned above are a reasonable benchmark when you discuss figures with your surgeon.
How to choose a revision surgeon and hospital, and red flags
Revision is not routine surgery, and the team matters. Ask whether the surgeon performs revisions regularly, whether the hospital holds a full range of revision implants and bone graft options, and whether it has anaesthesia, intensive care, blood supply and microbiology on site. Check the written plan names the implants and the technique. Red flags include a price quoted without scans, no examination of the cause, no plan for infection testing, promises of a perfect hip, and no follow-up arrangement at home. Read how our process works and ask the hospital to review your images through the free quote page.
Questions to ask the hospital
- What is the cause of my failure, and how did you decide?
- Which operation do you propose, and which implants?
- How many revision hip operations does the surgeon perform in a year?
- What happens if the operation is more extensive than planned?
- Who will manage my rehabilitation and follow-up once I am home?
Hospitals with Orthopedics in Turkey
Frequently asked questions
It is an operation to remove and replace all or part of an earlier hip replacement that has worn, loosened, become infected, dislocated or broken. It is more complex than a first replacement and depends on the cause.
Most primary hip replacements last 15 to 20 years or longer, though results vary with age, activity, weight and implant type. Registries record that a minority need revision, mostly for loosening, wear, infection or dislocation.
Approximate ranges are €8,000 to €25,000 in Turkey against about €15,000 to €35,000 in the UK. The price depends on how much is revised, the implants and bone graft needed, and the hospital stay. It is confirmed in writing after image review.
Most people get substantial pain relief and improved function, but outcomes are less predictable than a first hip replacement, and the chance of further surgery is higher. Results depend on the cause, bone loss and the surgeon's experience.
Hospital stay is usually four to seven days, walking aids are used for about six to twelve weeks, and most progress continues for six to twelve months. Bone grafting or a fracture can lengthen the timeline.
Pain is controlled with spinal or general anaesthesia and medication, and many people find the early recovery similar or somewhat harder than the first time, particularly after longer operations. Your team will plan pain relief.
Yes, but infection usually needs a specific plan, often removal of the implant, antibiotics and a one- or two-stage replacement. This is difficult to split across countries, so discuss it with a microbiology-supported team.
Plan on about 10 to 14 days: a few days of tests and surgery preparation, four to seven days in hospital, and time to be mobile and checked before flying. Complex cases may need longer.
Flying soon after major hip surgery raises the risk of blood clots. Surgeons generally wait until the wound is healing and you are walking, and advise blood-thinning medication, regular movement and hydration.
Yes. The implant brand, size and date, the original operation record and recent X-rays help the surgeon choose tools and replacement parts. Request them from your original hospital before you travel.
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