Revision Hip Replacement: What It Involves and How the Kley Rapid Hip May Reduce Your Risk

The goal can vary. Revision hip replacement removes, repairs or replaces part or all of an existing artificial hip.

It typically involves changing:

• The socket or liner
• The femoral head
• The stem inside the thigh bone
• Every component of the joint

Some revisions are relatively limited. Others require removal of well-fixed implants, reconstruction of lost bone and specialist revision components.

There are many factors to whether one is needed. Revision risk depends on age, implant type, surgical technique, component position and length of follow-up.

Historical National Joint Registry¹ data reported 15-year revision risks ranging from approximately 3.6% to almost 13%. Understandably, there’s higher rates among younger patients because their implants must function for longer.

One figure that's widely quoted for revisions is 21%. This figure does not mean one in five primary hip replacements fails within 15 years. It refers to hips that had already undergone one revision, of which 21% required another revision within 15 years.

It’s important to note that modern implants may perform better and shift a lot of these revision averages.

Aseptic loosening

• The bond between the implant and bone can weaken over time without infection. This may cause pain, movement and loss of surrounding bone.

Dislocation

• Recurrent dislocation may require revision to correct component position or improve stability with a different liner, socket or femoral head.

Deep infection

• Bacteria can attach to the implant and form a biofilm that is difficult to treat with antibiotics alone.
• Treatment may involve removing the implant, cleaning the joint, prolonged antibiotics and later inserting a new hip.

Wear and bone loss

• Wear particles can trigger osteolysis, causing bone to break down around the implant. Revision may be needed before the components become unstable.

Periprosthetic fracture

• A fall can fracture the bone around an artificial hip. Some fractures require fixation, while others need a longer revision stem.

As aforementioned, it can be much more complicated. Revision surgery usually takes longer than primary hip replacement because the surgeon must work through scarred tissues and remove existing components while preserving as much bone as possible.

The procedure may include:

• Removing cement or well-fixed implants
• Treating infection
• Rebuilding lost bone with grafts or metal augments
• Using longer stems or specialist sockets
• Restoring stability, leg length and hip mechanics

If infection is present, treatment may be completed in one operation or through a two-stage revision, with a temporary spacer and antibiotics between procedures. Not a simple process by any means.

Some operations are more straightforward than others. For revision surgery, recovery depends on the reason for revision and the complexity of reconstruction. Compared with primary hip replacement, it’s not uncommon for patients to experience:

• A longer hospital stay
• Greater blood loss and discomfort
• More time using walking aids
• Weight-bearing or movement restrictions
• A slower return to work and activity
• A higher risk of infection, dislocation or further revision

Officially, there is no fixed maximum number. But, it’s worth noting that each additional revision tends to become more difficult. This makes preserving bone, preventing infection and positioning components accurately during the first operation especially important.

The decision to proceed with a revision may hinge on:

• Remaining bone
• Muscle and soft-tissue function
• Infection
• Implant type
• General health
• Whether stable fixation can still be achieved

This is usually the source for needing revision surgery. Some of the most common causes are:

• Component positioning
• Joint stability
• Infection prevention
• Implant selection
• Soft-tissue preservation
• Restoration of leg length and offset

Some of the issues might occur more “naturally” – implants may loosen after many years, while fractures can occur after trauma. Careful primary surgery cannot eliminate lifetime risk, but it can reduce avoidable causes of failure.

At Orthopaedic Innovation, the Kley Rapid Hip pathway has been carefully designed to address several recognised causes of revision from the outset.

1. Dislocation

The procedure is led by Dr Kristian Kley. As of August 2026, he has recorded no dislocations across more than 3,000 UK Kley Rapid Hip procedures.

Of course, no surgeon can guarantee zero lifetime risk. But this means no patient in the reported series has required revision because of recurrent dislocation.

2. Infection

Across approximately 7,000 UK and European procedures, 3 infections (0.043%) have been recorded. We have also recorded no deep infection in our UK practice since 2019.

3. Digital planning

With modern technology, we’re able to simulate the implant positioning before every surgery. This allows us to review:

• Implant size
• Cup position
• Stem alignment
• Leg length
• Hip offset
• Individual bone anatomy

The more accurate the implant position, the less chance of instability, abnormal loading and accelerated wear.

4. Muscle preservation

This is also considered a “minimally invasive” procedure. 

What does that mean?

The Kley Rapid Hip works between the major muscles rather than routinely cutting through them. Preserving these muscles and soft tissues helps support joint stability and creates a more favourable tissue environment should future surgery ever become necessary.

5. Revision surgery included in our fixed price

For additional reassurance, our fixed-price Kley Rapid Hip package includes revision surgery at no further surgical cost where it is clinically required and falls within the terms of our revision cover.

Our aim is to minimise the chance of revision from the outset while providing a clear clinical and financial pathway if further surgery is ever needed.