Timing of the revision total hip replacement.

The purpose of this article is to define guidelines in regard to timing of revision surgery for total hip replacement. One important variable, in addition to incapacitating pain, is the presence of progressive bone loss associated with loose implants. Indications for revision are presented based on the immediacy of the situation. Timing for revision is categorized as immediate, delayed up to 6 months, delayed beyond 6 months, and elective. Clinical examples of indications are included. Useful diagnostic studies for evaluating the need for revision surgery are discussed. These procedures include several types of arthrography to aid in differential diagnosis.