Total hip arthroplasty has brought pain relief and mobility to many patients, but load bearing implants may fail and the resulting problems must be tackled early and with vigour. The primary operation offers the best chance of success, and revision may only ever be considered a salvage procedure. Patients with total hip arthroplasty must be offered facilities for an indefinite follow-up. Revision surgery is not to be undertaken lightly or on an occasional basis, and the lessons learned from such procedures must be used for the benefit of the patients undergoing primary operation.