Hip resurfacing can be an effective alternative to total hip replacement in certain patients. The goal of maintaining bone stock during hip resurfacing requires the use of metal implants, which have been shown to negatively impact women. Therefore, this procedure is best suited for men who hope to maintain an active lifestyle following surgery. In fact, hip resurfacing has become increasingly popular in recent years as more highly active patients and athletes are requiring treatment for their arthritic hips.
The hip is a ball and socket joint with the ball portion of the joint formed by the upper end of the thigh bone and the socket formed by the lower part of the pelvic bone. In total hip replacement, the entire ball and socket joint is replaced. On the other hand, hip resurfacing aims to remove the arthritic portion of the bone while preserving as much of the patient’s bone stock as possible.
During a hip resurfacing, the outer surface of the thigh bone (femur) is shaped to fit into the prosthesis, removing the painful arthritic surface in the process.Then, the resurfacing prosthesis is placed on top of the femoral head like a cap, creating a smooth surface. The bone itself is not invaded.
However, in a traditional total hip replacement, the neck of the femur is cut off and part of the prosthesis is placed down into thebone of the femoral neck for anchorage and stability. Therefore,more bone is removed during this procedure.
Although the implants are strong, most replacements eventually require a revision procedure due to wear, usually 15 to 20 years following the initial surgery. It is much easier to revise a hip resurfacing than it is a total hip replacement because more bone mass was preserved during the primary procedure. Further, the dislocation rate for hip resurfacing is lower due to the preservation of bone stock.
FAQs
Q1: What is hip resurfacing and how does it differ from total hip replacement?
Hip resurfacing is a bone-conserving alternative to total hip replacement in which only the arthritic surface of the femoral head is removed and capped with a smooth metal prosthesis, rather than removing the entire ball and cutting through the femoral neck as in total hip replacement. This approach preserves significantly more of the patient's natural bone stock, which is a critical advantage if revision surgery becomes necessary in the future and contributes to a lower risk of dislocation compared to traditional replacement.
Q2: Who is the best candidate for hip resurfacing surgery?
Hip resurfacing is best suited for active men who want to maintain a high activity level following surgery and have sufficient bone quality to support metal implants. Research has shown that the metal implants used in hip resurfacing can negatively impact women, making the procedure less appropriate for female patients. Active men and athletes dealing with hip arthritis who want to preserve bone stock and maintain long-term joint performance are typically the strongest candidates for this procedure.
Q3: What are the advantages of hip resurfacing over total hip replacement?
Key advantages of hip resurfacing include greater preservation of natural bone stock, a lower risk of hip dislocation, and a significantly easier revision procedure if the implant eventually wears out. While most hip implants require revision after 15 to 20 years, having more bone remaining from the original resurfacing procedure makes revision surgery more straightforward and more likely to be successful compared to revising a total hip replacement.
Q4: Is hip resurfacing a more complex procedure than total hip replacement?
Yes. Hip resurfacing is technically more demanding than total hip replacement and requires a higher level of surgical skill, precision, and experience to achieve optimal outcomes. The procedure involves carefully shaping the femoral head to fit the resurfacing prosthesis without invading the underlying bone, which demands advanced surgical technique. For this reason, choosing a surgeon with specialized expertise and experience in hip resurfacing is particularly important for achieving long-lasting and well-functioning results.
Q5: How long do hip resurfacing implants last?
Like all joint replacement implants, hip resurfacing prostheses are strong and durable but will eventually show wear over time. Most implants require a revision procedure approximately 15 to 20 years after the initial surgery. One of the significant advantages of hip resurfacing is that revision is considerably easier than revising a total hip replacement, because the bone-conserving nature of the original procedure leaves more natural bone stock intact to support the revised implant and improve the likelihood of a successful outcome.