Hip resurfacing may be an alternative to total hip replacement for young, active people who have good bone strength. If you have arthritic, damaged hip bones, but have good general bone strength, your hip may be able to be reshaped and resurfaced. The Center for Joint Care at UC San Diego Health has expert hip specialists who can assess whether you're a candidate.
Hip Resurfacing Advantages
- Quantity and quality of the thigh bone (femur) are preserved
- Head and neck of the femur are re-shaped, not removed
- Minimal amount of hip socket (acetabular) bone is removed for the insertion of proven, advanced resurfacing implant
- Minimal risk of leg length discrepancy
- Low risk of dislocation
- Maximum range of motion after surgery
- Revision is relatively easy and safe in the event of implant failure
- Patients are likely to return to high-impact activities such as tennis, skiing, surfing, basketball and cycling
- Low rates of failure
The current generation of hip resurfacing devices are made of cobalt chrome metal. They have a thin shell, a cementless acetabular component and a thin shell "cap" that is fixed to the femoral head with bone cement. Studies show high success rates and low rates of failure for these types of metal-on-metal hip resurfacing devices.
About Hip Resurfacing
The surgery takes approximately two hours. During surgery, the hip joint is exposed and the damaged surface of the head of the femur is reshaped. A new femoral head cap is placed over this prepared surface and fixed in place with bone cement. The damaged surface of the acetabulum (hip socket) is then prepared and a new, thin shell cup is inserted securely into the hip socket. The bone of the socket grows onto the surface of the new cup for fixation.
When the components are in place, the skin is closed with absorbable sutures that dissolve and therefore do not need to be removed. Patients have physical therapy sessions twice a day while in the hospital, and are instructed on the use of crutches or a walker. The hospital stay is usually two to three days.
Recovery and Rehabilitation
Most people will participate in supervised
physical therapy for about four weeks and use assistive devices such as crutches for a couple weeks after surgery to reduce pressure on the hip while the operative site heals and while discomfort subsides. Low-impact activities such as walking, cycling and golf are allowed as soon as you feel comfortable doing them. Higher impact activities such as jogging or tennis should be avoided for at least six months while the bone of the hip strengthens as it adjusts to the new device.
Are You a Good Candidate?
The first thing to consider is your level of pain and how badly your hip is affecting your quality of life. Next the decision is between a total hip replacement and hip resurfacing. Generally, if you are young and active, you are at an increased risk for a total hip replacement to eventually fail. For this group of patients, hip resurfacing may be advantageous because bone is preserved with this surgery which allows for future reconstruction if the device fails down the road. Simply put, resurfacing procedures are more easily revised than total hip replacements.
A review of your X-rays by your surgeon will be the final determining factor. If you have good bone quality and no major anatomic abnormalities, you are likely a good candidate. Just like a house, the resurfacing must be done on a solid foundation.
Hip resurfacing may not be for everyone, including patients with:
- Poor bone quality
- Severe, extensive osteonecrosis or avascular necrosis