Birmingham Hip Resurfacing Procedure
Hip Resurfacing vs. Hip Replacement
Hip resurfacing, a procedure that improves the function of your own hip joint, may be a viable alternative to total hip replacement surgery. Find out if you're a good candidate.
By Madeline R. Vann, MPH
Medically Reviewed by Niya Jones, MD, MPH
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Your hip is one of the largest joints in your body, operating as a ball and socket. The pain and stiffness of arthritis in that joint can dramatically impact your quality of life and may lead you to consider hip replacement surgery. Yet for younger patients with otherwise strong bones, a procedure known as hip resurfacing may actually be a better bet.
Hip Resurfacing Surgery: What Is It?
“Hip resurfacing is an alternative to hip replacement,” says Thomas Parker Vail, MD, professor and chairman of orthopedic surgery at the University of California, San Francisco. “The difference when you are doing a resurfacing is that you are capping the ball [portion of the hip joint], and with a hip replacement you are removing the ball.”
In hip resurfacing surgery, your orthopedic surgeon will smooth away some of the tissue and bone in your hip joint. A metal cap will then be placed over the so-called ball (the cartilaginous tissue that protects the top of your femur or thigh bone) and a metal cup will be placed on the inside of the hip socket to allow the joint to function more smoothly.
Hip Resurfacing Surgery: Who Is a Good Candidate?
Hip resurfacing is ideal for people who don't have other joint or bone disorders (such as osteoporosis) besides the arthritis causing their hip pain. If you are under 55 and have otherwise healthy bones, this may be a better option for you than a total hip replacement.
This procedure does not make sense for everyone with hip arthritis, however. "It’s for a subset of patients who have pain and stiffness but happen to have good bones," explains Dr. Vail. "If the bone is deteriorated or weak, there's a greater risk that the cap might come loose or the bone might break." People with osteoporosis or those who have a condition known as avascular necrosis of the hip (which leads to severe joint destruction due to poor blood flow) are not candidates for hip resurfacing.
Hip Resurfacing Surgery: Pros
The average age for a total hip replacement is 68, says Vail. Even though newer hip replacement implants last for up to 20 years, surgeons typically want to conserve as much natural bone as possible in younger patients. For this reason, hip resurfacing is attractive because it allows a larger portion of the natural joint to remain intact. This also enhances mobility. “The idea of preserving bone is a worthwhile endeavor because I don’t believe that any operation you can do will last forever,” says Vail.
Another advantage of hip resurfacing is faster recovery time. In most cases, the recovery period after hip resurfacing is shorter than with a total hip replacement.
Hip Resurfacing Surgery: Cons
Despite the possible benefits, there are some drawbacks to hip resurfacing. It carries all the usual risks of surgery, including blood clots, infection, and complications of anesthesia.
As with hip replacement surgery, you are also at increased risk of dislocating your revised joint after surgery. Working with a physical therapist before and after either hip resurfacing or hip replacement surgery can help you learn how to protect the joint as you are healing.
There are a few concerns, however, that are specific to hip resurfacing. One study of over 500 hip resurfacing surgeries found that younger men had the best outcomes, while women did not fare as well. Post-menopausal women in particular may have bones that are not well-suited for hip resurfacing. Poor outcomes were more common in female patients, patients over the age of 55, and patients whose surgeons had done 10 or fewer hip resurfacing procedures.
The study also revealed an increased risk of fracture of the femoral neck (the top part of the thigh bone), which is not typically a risk associated with hip replacement surgery. This type of fracture can be very serious and require another surgery to treat it.
Vail also points out that even some people who undergo successful hip resurfacing may later require a total hip replacement if their symptoms recur. Finally, he adds, “Another critical piece of hip resurfacing is finding a surgeon who has experience doing it — it is not as commonly done as hip replacements.”
Work with your orthopedic surgeon to determine whether hip resurfacing is a good option for you. No matter which type of hip procedure you ultimately choose, make sure you follow your doctor’s instructions closely before and after surgery to reduce your risk of complications.
Video: Birmingham Hip Resurfacing - Updated procedure
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