Hip Resurfacing

Hip Resurfacing is an alternative to Hip Replacement surgery and it involves replacing the diseased or damaged surfaces in the hip joint with metal parts. Less bone is removed, so less prosthetic (implant) is needed.

 

Hip Resurfacing is likely to last longer than a conventional replacement joint, which may start to wear after 10-20 years. Therefore, hip resurfacing is recommended for younger people (under the age of 65) with advanced hip disease who are likely to outlive a hip replacement.

 

With newer materials, the artificial joint implants used in total hip replacement last about 15 years. Hip resurfacing might be a better choice for younger people because the procedure leaves more bone intact, which can make it easier to perform a total hip replacement if needed later.

 

Surgeons perform Hip Resurfacing using several different incisions, or approaches, to the hip joint. The anterior approach is from the front of the hip and the posterior approach from the back of the hip. Either approach is commonly used depending on the training and experience of the surgeon.

 

In this operation, surgeon makes an incision in the side of the thigh. This allows the surgeon to see both the femoral head and the acetabulum (or socket). The femoral head is then dislocated out of the socket. Special powered instruments are used to shape the bone of the femoral head so that the new metal surface will fit snugly on top of the bone.

 

The cap is placed over the smoothed head like a tooth capped by the dentist. The cap is held in place with a small peg that fits down into the bone. The patient must have enough healthy bone to support the cap.

 

The hip socket may remain unchanged but more often it is replaced with a thin metal cup. A special tool called a reamer is used to remove the cartilage from the acetabulum and shape the socket to fit the acetabular component. Once the shape is correct, the acetabular component is pressed into place in the socket. Friction holds the metal liner in place until bone grows into the holes in the surface and attaches the metal to the bone.

 

After surgery, your hip will be covered with a padded dressing. Special boots or stockings are placed on your feet to help prevent blood clots from forming. A triangle-shaped cushion may be positioned between your legs to keep your legs from crossing or rolling in.

 

Physical therapy treatments are scheduled one to three times each day of your stay in the hospital. First session is scheduled soon after you wake up from surgery. Your therapist will begin by helping you move from your hospital bed to a chair. By the second day, you'll begin walking longer distances using your crutches. Most patients are safe to put comfortable weight down when standing or walking. However, if your surgeon used an uncemented prosthesis, you may be instructed to limit the weight you bear on your foot when you are up and walking.

 

Your therapist will review exercises to begin toning and strengthening the thigh and hip muscles. Ankle and knee movements are used to help pump swelling out of the leg and to prevent the formation of blood clots. To prevent dislocation, patients follow strict guidelines about which hip positions to avoid. Patients are usually able to go home after spending two to four days in the hospital.

 

Patients are usually able to drive within three weeks and walk without a walking aid by six weeks. Heavy sports that require jogging, running, jumping, quick stopping and starting, and cutting are discouraged. Repetitive impact can strain the resurfacing, increasing the risk of loosening.

 

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