Hip Resurfacing

About Hip Resurfacing

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Risks of Hip Resurfacing

Surgical Expertise

Your Questions

• How long does the surgery take?
  
• Where will I have my hip resurfacing surgery?
  
• How long will it be before I can take a shower or bath?
  
• When can I drive a car?
  
• Should I put any ointment or treatments onto the incision site?
  
• When do I come back to see my orthopaedic surgeon?
  
• Are there activities I should do?
  
• When will I be able to return to work?
  
• When can I start playing tennis or golf or other sports?
  
• Is occasional ‘clicking’ in the hip normal?
  
• Will the implant set off metal detectors at airports?
  
• Are there range of motion restrictions / ‘hip precautions’ after surgery?
  
• When can I resume sexual activities?
  
• How long should I keep doing the prescribed post-operative exercises?
  
• When does the tape come off my wound?
  
• How long will my hip resurfacing last?
  
  
  
  
• How long does the surgery take?
  Approximately 1½ -3 hours, depending on the condition of your hip at the time of surgery.
  
  
• Where will I have my hip resurfacing surgery?
  Your surgery will be performed at UCSD's Thornton Hospital, located in beautiful La Jolla, Calif. See pictures of the hospital and get directions.
  
  
• How long will it be before I can take a shower or bath?
  You may shower 3 days after surgery if the wound is dry. Keep water exposure to the incision site brief and blot it dry when you get out.  Do not bathe or swim or Jacuzzi (ie. Do not submerge the incision) for approximately 3 to 4 weeks.
  
  
• When can I drive a car?
  This question is impossible to generalize to everyone because it is largely dependent on the individual.  Importantly, doctors do not have a license with the DMV to “clear you” or “release you” to return to driving.  There are 3 primary criteria that must be met.  You need to be off of narcotic pain medicines (otherwise you are driving under the influence).  You need to be able to get in and out of the driver’s seat comfortably.  And you must have regained your normal reflexes / strength.  Also, return to driving depends partly on what side had surgery (ie. Right leg operates the pedals; people with Left side surgery can generally get back to driving much sooner unless you have a clutch).  The average time to return to driving is around 4 weeks for the right side and usually sooner for the left.  We recommend ‘testing’ yourself with another licensed driver in an empty parking lot or quiet street first in order to check your reflexes moving your foot from pedal to pedal.
  
  
• Can I sleep on both sides?
  You can generally sleep on either side, on your stomach or on your back.  How soon before you sleep on your side is mostly dependent on your comfort level because it is usually uncomfortable to put your weight on the operative side for a few weeks.  If you do sleep on your side, you should keep pillows between your legs both for comfort and for hip stability.
  If you sleep on your stomach, you must be careful getting into this position keeping your hip precautions in mind while you turn.
  
  
• Should I put any ointment or treatments onto the incision site?
  For the first 2 weeks you should just keep the incision site dry.  Typically there will be a ‘wound glue’ applied at the time of surgery and / or ‘steri-strips’ or ‘butterfly bandages’.  These usually begin to come off at about 2 weeks after surgery.  At that time you may begin to apply products such as Mederma ointment, Vitamin E ointment or silicone wound coverings.
  
  
• When do I come back to see my orthopaedic surgeon?
  Generally, you should return to see your surgeon at the following intervals, but this may be individualized depending on special circumstances.
  
  Follow-up appointments (from date of surgery):
  
  • Approximately 4 weeks after surgery
  • Approximately 4 to 6 months after surgery
  • One year after surgery
  • 2 years after surgery
  • Then once every 2 to 4 years.

X-rays are an important part of each follow-up visit and essential in determining the amount of bone ingrowth, position of the implant, and the condition of the bone around the implant. Also, x-rays can tell us if any parts are wearing out prematurely.

• Are there activities I should do?
  A number of activities and exercises will be described / taught by your physical therapist.  Additionally, an exercise bike can be quite helpful.  Keep the seat of the bike high to avoid extreme hip flexion.  Within the first couple of weeks after surgery, the bike should be used as a motion machine; pedal with non-operative leg and let your operative leg ‘go along for the ride’.  Use low resistance, low speed and short durations initially.  After a few weeks, you can start to add a little resistance and duration as you can tolerate it.  Additionally, after approximately 3 to 4 weeks, aqua therapy (pool exercises) are encouraged.  The buoyancy of the water can make strengthening and gait training more comfortable because there is less load applied to the operative leg.
  
  
• When will I be able to return to work?
  This varies depending on the demands of your job.  Some ambitious patients return to desk jobs / administrative type work as early as 1 week after surgery (but usually more like 1 month).  For active labor or heavy labor, it may take 3 to 6 months to return to work. 
  
  
• When can I start playing tennis or golf or other sports?
  Active sports should be delayed until you have weaned off of crutches and are walking comfortably.  For golf, patients can usually get back to practicing their ‘short game’ around 1 to 2 months after surgery and get back into the full swing after 3 to 6 months.  Tennis usually takes a little longer because it is higher demand.  Start slow to be sure that you have regained adequate strength and gradually increase your activity as tolerated.  You should avoid impact activities for approximately 6 months after hip resurfacing (including jogging, pivoting sports like tennis and basketball, aggressive skiing, parachuting, etc.).  This time allows the bone in the femoral head and neck to strengthen and get accommodated to the new stresses applied through the resurfacing device.
  
  
• I have noticed occasional ‘clicking’ in the hip.  Is that normal or should I be worried?
  Approximately one-third of patients (30%) will experience some sensation of clicking in the hip after surgery.  It usually goes away after a few months.  This ‘clicking’ has not been associated with anything bad.  It is usually painless and happens just with certain positions.  Patients with clicking are not at increased risk of dislocation or failure of the device.  No increased wear of the parts has been seen in patients with clicking.  It probably occurs because of mild post-operative muscle atrophy and atony, and because it takes the hip joint capsule at least a couple of months to heal.  Again, in most patients it goes away, and it has not been associated with any specific problem.
  
  
• Will the implant set off metal detectors at airports?
  Yes, they usually do. The clinic can provide you with a card that documents your hip resurfacing device.  However, with the increased airport security lately, you should allow an extra 10 to 15 minutes to get through the airport.
  
  
• Are there range of motion restrictions / ‘hip precautions’ after surgery?
  Hip resurfacing replaces your joint with approximately the same size ball and cup that you had before surgery.  This provides you with a very stable joint.  However, resurfacings can dislocate.  In order to allow the soft tissues to adequately heal, you should avoid a position of combined flexion / adduction / internal rotation.  This position is simulated when you bring the knee of your operative leg up toward the opposite shoulder or when you bring the opposite shoulder down toward the knee of the operative leg.  It involves hip flexion and simultaneously bringing the knee across the midline of your body.  This should be avoided for the first 3 months after surgery to allow sufficient soft tissue healing.
  
  
• When can I resume sexual activities?
  There is no specific time frame.  Basically, you can resume such activities when your hip is comfortable enough to allow it.  Of course, you should avoid positions that place too much stress on the hip.  The therapist can review safe techniques.
  
  
• How long should I keep doing the prescribed post-operative exercises?
  You should do the exercises given to you at discharge until you return for your four-week visit. At that time, you may be given a new set of exercises. You should continue to exercise until your muscles are pain-free and you can walk without a limp. It is a good idea to continue your exercises as a lifetime commitment to keep your muscles strong.
  
  
• When does the tape come off my wound?
  At the time of surgery tape-like strips may be placed on your incision to protect it.  These will eventually come off on their own in one to two weeks, or you may remove them yourself after two weeks.
  
  
• How long will my hip resurfacing last?
  The durability of hip resurfacing implants is quite good.  The longest follow-up studies so far have patients now 5 to 10 years post-surgery.  Results tend to vary slightly from study to study, but a fair estimate is approximately 95% revision-free survival of the surgery at 10 years. Or, in other words, in a group of 100 patients with hip resurfacings, there may be one patient who needs a revision to a total hip every 2 years.  These are quite good early results given the young age and high activity level of the average hip resurfacing patient.