September 26, 2018 | Staff
Arthritis of the hip, in most cases, is a wearing away of the cartilage on the ball and socket of the hip joint, leading to painful rubbing of bone on bone. Patients with hip problems, including arthritis of the hip, now have options beyond a hip replacement. Hip resurfacing is a more conservative procedure with greater benefits. Rather than replacing the entire hip joint, as in a total hip replacement, hip resurfacing involves shaving and capping only a few millimeters of the joint surface. Since this approach preserves more of the patient's natural bone, it reduces postoperative risks of dislocation and inaccurate leg length.
The hip joint can be thought of as a ball and socket joint between which lies a lubricating and protective layer known as cartilage. When cartilage loss occurs (a condition known as arthritis), the patient experiences pain as well as a loss of mobility and function.
With both traditional hip replacement and surface replacement, the socket is inserted in a similar fashion. The two procedures differ in the way the femur is prepared. With traditional hip replacement, the head and neck of the femur are removed, surface replacement preserves this bone. With a traditional hip replacement, after this bone is removed, a prosthetic ball attached with a stem is inserted within the thigh bone. With a surface replacement, the preserved bone is sculpted to accept a metal cap with a short stem.
In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement.
Your doctor may recommend surgery if you have more advanced osteoarthritis and have exhausted the nonsurgical treatment options. Surgery should only be considered if your hip is significantly affecting the quality of your life and interfering with your normal activities.
However, hip resurfacing is not suitable for all patients. The best candidates for hip resurfacing are younger (less than 60), larger-framed patients (typically male) with otherwise strong, healthy bone. A comprehensive evaluation by your orthopedic surgeon will help you determine if you are a good candidate for hip resurfacing.
Hip Resurfacings May Be Easier to Revise
Since the implants used in both hip replacements and hip resurfacings are mechanical parts, they often wear out or loosen over time. This typically occurs between 10 and 20 years after the procedure. If an implant fails, a "revision" operation may be necessary. This second procedure can be more complicated than the initial operation. However, since hip resurfacing removes less bone from the femur (thighbone) than a traditional hip replacement, many surgeons believe it is easier to exchange implants that fail after hip resurfacing.
Decreased Risk of Hip Dislocation
The size of the ball in hip resurfacing is larger than in a traditional hip replacement and is closer to the size of the natural ball of your hip. Because of this larger size, it may be harder to dislocate.
More Normal Walking Pattern
Several studies have shown that walking patterns are more natural following hip resurfacing when compared to traditional hip replacement. These differences in walking are often quite subtle.
Femoral Neck Fracture
A small percentage of hip resurfacing patients will eventually experience a fracture of the thighbone at the femoral neck. If this happens, you will typically need to switch to a traditional hip replacement. A femoral neck fracture is not possible with a traditional hip replacement since the femoral neck is removed during this procedure. However, fractures around the implants can still occur with a traditional hip replacement.
Metal Ion Risk
With a hip resurfacing, a metal ball moves within a metal socket. Over time, this leads to the production of tiny metal particles called ions. Some patients may develop an allergy or sensitivity to the metal particles, which can cause pain and swelling. There are also concerns that the metal particles can increase the risk of cancer, although this has not been proven thus far.
Hip Resurfacing Is More Difficult
Hip resurfacings are more difficult than total hip replacements for surgeons to perform. As such, a larger incision is usually required for a hip resurfacing.
As with any surgical procedure, there are risks involved with hip resurfacing. Be sure to discuss each of the risks with your surgeon so you fully understand the potential complications that may arise.
Although rare, the most common complications of hip resurfacing are:
For the past 40 years, millions of people have experienced relief from hip pain and arthritis and enjoyed restored mobility through total hip replacement. Hip replacement surgeries are surprisingly more routine than you may think and are performed on millions of patients worldwide each year. To diagnose your condition, an orthopedic surgeon will perform a thorough examination of your hip, analyze X-rays and conduct physical tests.
The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. To learn more about the procedure or to schedule an appointment with one of our hip replacement specialists, call us at 800.698.1280.