What is hip resurfacing? It’s a conservative artificial joint replacement, where the hip joint is relined instead of being completely replaced (as in total hip replacement).
Hip resurfacing surgery aims to provide a more active and improved quality of life. This is done by restoring functionality to the hip by replacing damaged bone and cartilage in the socket while preserving as much natural bone as possible.
“With a hip resurfacing, I do not cut the femoral head off,” explains Dr. Shah, “Instead, I shape the femoral head to make it spherical and pegged. Then instead of a femoral stem in the thigh, I place a metal cap with a short peg on the retained femoral head and implant a metallic shell into the socket. While the socket side of the surgery is not too different, the femur side is drastically different. This means that there is less bone loss from the femur and a more anatomic and normally sized femoral head.”
Keep reading to learn more about who should have hip resurfacing and what patients should expect before, during, and after having the procedure.
Candidates for Hip Resurfacing
As with any procedure, your hip surgeon will inform you if you are a candidate for this procedure. However, many candidates for hip resurfacing tend to be under 60, with strong, healthy bones, as it leaves more bone intact.
Hip resurfacing surgery can address pain from mild to moderate osteoarthritis before significant bone damage has occurred.
Hip replacement surgery may not resolve referred pain from the back, poor circulation, or damaged nerves. So you should consider this type of joint surgery if:
- You have tried all conservative treatments and not found success
- You are experiencing debilitating and severe pain with loss of function.
What Is Hip Resurfacing: The Procedure
So, what is hip resurfacing, and what can you expect? Hip resurfacing surgery may be performed as an overnight procedure, and you may be walking within four hours after the surgery.
The surgery usually takes two to three hours of operating time and an additional hour in the recovery room after surgery. During the procedure, the surgeon will:
- Make an incision of approximately 20–30 centimeters over the outer edge of your hip joint.
- Remove the damaged bone surface only by about four or five millimeters from the head of the femur and approximately four or five millimeters from the socket (acetabulum).
- Replace the bone surface with a metal cover or shell.
- Close the surgical cut with sutures and at the skin with staples. (The staples must be removed a fortnight after surgery while the sutures will dissolve. The dressing is designed for compression and will stay in place for 48 hours.)
Advantages of Hip Resurfacing
Hip surgery has undergone enormous developments, and with a hip resurfacing procedure, there are many advantages compared to the traditional total hip replacement.
Ease of Revision
One of the main benefits of hip resurfacing is preserving the femoral neck and femoral canal, thus leaving the option open for a total hip replacement if needed in the future.
Hip resurfacing minimizes bone removal and uses a smaller implant so that the revision surgery can be performed like a standard hip replacement.
Hip resurfacing uses a chrome cobalt and molybdenum combination device, smaller than a traditional total hip device. The smaller device helps the patient get back to mobility sooner with a rapid, postoperative rehab program.
Minimal Bone Removal
Hip resurfacing surgery removes less bone as it retreads the bone with a metal prosthesis instead of removing the entire ball of the ball and socket hip joint.
A metal cap is placed around the ball, where the cartilage has worn off, reducing the amount of bone removed.
Less Risk of Dislocation
In hip resurfacing, the bone around the implant supporting the metal cap remains healthy and strong.
The resurfaced ball is more similar in size to the natural femoral head, which reduces the risk of dislocation. There is greater stability of the hip joint from the hip resurfacing implant, resulting in a dramatic reduction of dislocation rates.
It also reduces the problem of leg-lengthening or shortening.
Shorter Recovery Time
Many hip resurfacing patients are back walking just four hours after surgery. The total time spent in the hospital is approximately one to two days. Most patients can get back to regular activities, like driving, within two or three weeks.
Hip Resurfacing Complications
There are risks involved with hip resurfacing, like any surgical procedure. You can discuss common complications with your physician and take specific measures to help avoid potential problems post-surgery.
Although rare, the most common complications of hip resurfacing are:
- Leg vein blood clots
- Injury to the nerves or blood vessels
- Dislocation of the hip joint
- Weakening or softening of the bone causing collapse or fracture of the femoral neck