(ii) Implant removal in revision hip surgery

Implant removal is a major part of revision hip surgery. A complication, such as fracture or perforation during implant removal, more common in the presence of surrounding osteopenia, can compromise subsequent reconstruction. Similarly, care must be taken to avoid additional bone loss during implant removal. Various techniques are available on both the femoral and acetabular sides that can facilitate the procedure. Recent developments in instrumentation can prove helpful.In this article the techniques are reviewed. In addition, the importance of pre-operative planning and exposure is discussed. The techniques used to remove both cemented and uncemented implants are detailed with examples, illustrations and practical tips. The overall aim of the article is to make this potentially complicated procedure less challenging for the surgeon, but more importantly, to reduce complication rates in implant removal, improving clinical outcomes for patients.