Hip Resurfacing:

What is hip resurfacing?

In this modern alternative to hip replacement, only the worn out surfaces of the hip joint are replaced.

It is a bone preserving operation as most of the head and neck portion of the top end of the femur bone is retained. The head and neck portion of the femur bone is sculpted to a cylindrical stump and not chopped off. A metal ball like cap is fixed with cement over this cylindrical stump. On the socket side also, the worn out lining is scraped out and a metal implant or shell is impacted.

The surface components are made of metal, either Metasul or Cobalt chrome. The outer side of the socket is lined with either a porous metal or hydroxyapatite coating. The components match the normal size of the natural bone and are of larger diameter than the components of a total hip replacement. The lining surfaces are highly polished to give a low friction finish thus leading to reduced wear. Several companies have introduced resurfacing devices. The Birmingham hip replacement (BHR) has the longest clinical follow up of over a decade today.

Hip resurfacing is intended to produce pain relief in young and middle aged active patients with hip arthrosis or arthritis. It is not advocated when there is advanced bone loss. Patients younger than 55 to 60 years are the ideal candidates. It could also be considered in active males up to 65 years after due consideration is given to bone density and quality. It is not recommended in females of child bearing age & over 55 years as the risk of complications increases. A hip resurfacing offers significant advantages over hip replacement in this selected group of patients. According to the NICE study, hip resurfacing is the procedure of choice for hip arthritis in patients younger than 65 years.

Total hip replacement is the tested and proved operation for hip arthritis in elderly patients over 70 years of age. A total hip replacement is also the preferred treatment for femoral neck fracture in this age group.

Advantages of hip resurfacing surgery are

• Suitable for young patients
• Long lasting
• Minimally invasive to bone
• Cost effective
• Faster recovery vs THR.
• Easier to revise to THR as bone is preserved
• Allows normal range of movement
• Least incidence of dislocation
• Least incidence of loosening as plastic is not used

Life after Hip resurfacing

A Hip resurfacing operation rapidly fixes hip pain and allows return of full function. There are no restrictions on activities and many patients have returned to sports after hip resurfacing with the BHR. Resurfacing hip surgery is less traumatic than traditional total hip replacement. Risks after hip resurfacing are similar to those for a total hip replacement.