Total Hip Resurfacing
Total hip resurfacing is a procedure that may be performed to treat patients who are suffering from advanced arthritis in the hip. During the process, only damaged cartilage is removed and a metal cap is placed over the ball portion of the hip. The procedure is similar to that of hip replacement surgery, but in a hip resurfacing, the femoral head and socket are not removed. Hip resurfacing is typically performed on young patients or patients with medical conditions that preclude full hip replacement surgery.
Candidates for Total Hip Resurfacing
Good candidates for total hip resurfacing are typically patients who have severe damage to the hip due to arthritis. These individuals have usually tried more conservative forms of treatment but obtained little relief of their symptoms. Total hip resurfacing is frequently most successful in patients under the age of 60 with large frames and healthy, dense bones. Patients who do not meet these criteria may be evaluated for the procedure, but are considered at increased risk of complications.
Advantages of Total Hip Resurfacing
There are several reasons why a total hip resurfacing procedure may be recommended. The benefits of undergoing a total hip resurfacing procedure rather than a hip replacement often include:
- Less complicated revision surgery if necessary
- Fuller range of motion in the hip
- Lower risk of hip dislocation
- More normal gait than after full hip replacement surgery
Disadvantages of Total Hip Resurfacing
While total hip resurfacing can be a very effective form of treatment, it is not the right procedure for every patient. It can be a more challenging type of surgery to perform than a hip replacement, and often necessitates the use of a larger incision. Total hip resurfacing also puts the patient at risk for developing a fracture toward the top of the thighbone in the femoral neck. Since the femoral neck is removed during a replacement surgery, this risk is not associated with that procedure. Additionally, some patients have an allergic reaction to the metal ion particles produced after full hip replacement surgery that does not occur during the resurfacing procedure.
The Total Hip Resurfacing Procedure
The total hip resurfacing surgery is performed with the patient under general anesthesia and usually takes between 1.5 and 3 hours. After an incision is made in the thigh, the surgeon will ease the femoral head out of the socket. Once the cartilage covering the femoral head is removed, tools are used to reshape the head before a metal covering is placed on top of it. When this implant has been positioned correctly, the femoral head is reinserted into the socket. The incision will then be sutured closed.
Recovery from Total Hip Resurfacing
Total hip resurfacing is an inpatient procedure, with patients typically requiring a hospital stay of 1 to 3 nights. Most patients require the use of an assistive device, such as crutches or a walker, temporarily after the surgery, as well as physical therapy to help them regain strength, flexibility and range of motion. Most patients will be ready to return to normal daily activities approximately 6 weeks following the procedure.
Risks of Total Hip Resurfacing
While total hip resurfacing is considered a generally safe procedure, all forms of surgery carry some risk. The risks that may be associated with total hip resurfacing include infection, development of blood clots, femoral neck fracture, hip dislocation, damage to nerves or blood vessels, and reactions to anesthesia. Although total hip resurfacing surgery is less complex than complete hip replacement, resurfacing does not have as long a track record and so far appears to be associated with a higher risk of complications