What is hip resurfacing?
Active and younger individuals can suffer from hip osteoarthritis. Hip osteoarthritis occurs when the articular cartilage on the end of the hip bone and on the socket wears away. This leaves an uncomfortable bone-on-bone condition which is painful and can be debilitating. The resulting inflammation causes hip osteoarthritis. Hip resurfacing is a type of hip replacement; however, instead of replacing the entire hip joint, hip resurfacing involves the shaving of the surface of the femur and the acetabulum (hip socket), and then capping it with a new joint surface. This approach preserves more of the patient’s natural bone and reduces the risk for postoperative dislocation and inaccurate leg length. The experts at BICMD can diagnose your hip condition through their orthopedic telemedicine platform and can advise you of your best treatment options and if you are a candidate for hip resurfacing.
What is the difference between hip resurfacing and a hip replacement?
In a conventional hip replacement, the portion of the hip with osteoarthritis is removed and replaced by a new ball and socket. The original ball of the femur is cut and removed to allow a stemmed prosthesis to be placed in the marrow cavity of the thigh bone. A ball is affixed to the top and is then inserted into a new acetabulum, or socket which is fitted into the pelvis. The joint moves easily with the help of a spacer and osteoarthritis joint pain is eliminated.
Hip resurfacing is a surgical technique that differs completely in the way the thigh bone is treated. Instead of removing the ball at the top of the femur, it is shaved down in millimeters, to a peg. The process is often compared to how a dentist prepares a tooth for a new crown. The femoral “peg” is then fitted to a metal ball that is placed around it, capping the top. The acetabulum is treated in a similar manner to the hip replacement, in that an artificial “cap” is fixed to the socket on the preserved bone.
Why would I choose hip resurfacing surgery?
Hip resurfacing surgery is not suitable for all patients. Younger candidates have better post-operative outcomes (younger than 60) as well as men with strong healthy bone. Larger-framed patients also do better with hip resurfacing than with a traditional hip replacement. The benefit of resurfacing is that it preserves more of your bone and delays the need for a total hip replacement. Our specialists at BICMD have extensive experience with hip resurfacing and can tell you if you would be an ideal candidate. If not, they can help you decide on the best hip treatment for your condition through a telemedicine visit. Younger patients enjoy other benefits of hip resurfacing, such as:
- Quicker return to normal activities and lifestyle
- Resurfaced hips do not have the limitations of a new hip
- Hip resurfacing can last longer than a traditional hip replacement
- More of the bone is retained
- It is very unlikely for the resurfacing material to “pop out” or dislocate
- Post-operative hip functions at a higher level than a complete hip replacement
How is a hip resurfacing surgery performed?
Under general anesthesia, the orthopedic surgeon makes an incision in the thigh to access the hip joint. The femoral head is brought out of the socket and trimmed with specialized equipment. A carefully fitted metal cap is then cemented over the femoral head. Next, the cartilage that lines the acetabulum, or the socket is removed, and a metal cup is placed into the socket. Finally, the femoral head is relocated back into the socket and the incision is closed.
What are the risks of hip resurfacing?
- There is a slight risk (1-2%) of fracturing the femoral neck.
- Surgery is more exacting and technically challenging, making it more difficult to find a qualified surgeon.
- Not recommended for older individuals.
- Although rare, injury to nerves or vessels can occur.
How long does the resurfacing of a hip last?
The materials used in hip resurfacing have improved drastically in the last 10-15 years. Two metal implant surfaces eliminate concerns about the plastic portion of a hip replacement wearing out. The most recent data shows hip resurfacing to last as long, if not longer than a hip replacement. Some hip resurfacings have survived up until the 15 to 20 year-mark.
How long is the recovery following hip resurfacing surgery?
Hip resurfacing is done on an in-patient basis. Patients can go home in 1 to 3 days, depending on your surgeon’s recommendations. In general, patients can expect the following:
- Weight bearing as tolerated, immediately after surgery.
- Expect to use a walker, cane or crutches until full weight bearing is possible.
- Pain and discomfort are normal after surgery and can be controlled with medication, taken as directed.
- Exercises will be needed to regain full range of motion and strength.
- Physical therapy is also recommended.
Most patients can expect a shorter recovery time than hip arthroplasty, or replacement. Hip resurfacing patients can expect to return to normal activities in about 1-2 months.
For more information on hip resurfacing, or the correct treatment for your hip condition, and to receive a second opinion for your hip osteoarthritis, please contact our experts, by clicking on “Connect With a Doctor.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.