Hip resurfacing surgery

Hip resurfacing may be necessary for individuals experiencing severe hip pain and limited mobility due to conditions like osteoarthritis, rheumatoid arthritis, or hip dysplasia. It's often recommended when conservative treatments like medication and physical therapy no longer provide sufficient relief. Hip resurfacing preserves more of the patient's natural bone compared to total hip replacement, making it a preferred option for younger, more active individuals who may require future hip surgeries. Additionally, hip resurfacing can offer greater range of motion and stability compared to traditional hip replacement, allowing patients to maintain their quality of life and continue with activities they enjoy.

Who is a candidate for hip resurfacing?

• Are young and active: Hip resurfacing is often recommended for younger patients with good bone quality who have a high level of physical activity and may require future hip surgeries.

• Have healthy bone: Candidates should have sufficient bone density and quality to support the hip resurfacing implants. Conditions like osteoporosis may affect candidacy.

• Experience severe hip pain: Candidates typically experience significant hip pain, stiffness, and limited mobility due to conditions such as osteoarthritis, rheumatoid arthritis, or hip dysplasia.

• Have minimal bone deformity: Hip resurfacing is most effective for patients with minimal bone deformity or damage to the femoral head and acetabulum.

• Seek joint preservation: Candidates may prefer hip resurfacing over total hip replacement to preserve more of their natural bone and potentially delay or avoid the need for future revision surgeries.

• Have failed conservative treatment: Candidates may have tried conservative treatments like medication, physical therapy, or joint injections without adequate relief of symptoms.

• Have realistic expectations: Candidates should have realistic expectations about the outcomes and limitations of hip resurfacing surgery, including potential risks and complications.

Step-by-step procedure for hip resurfacing

1. Preparation: The patient is prepped for surgery, which may involve fasting and discontinuation of certain medications as advised by the healthcare provider.

2. Anesthesia: General anesthesia or regional anesthesia (spinal or epidural) is administered to ensure the patient is comfortable and pain-free during the procedure.

3. Incision: A single incision is made to access the hip joint. The location and size of the incision may vary depending on the surgeon's preference and the patient's anatomy.

4. Hip exposure: The surgeon carefully dislocates the hip joint to gain access to the femoral head and acetabulum (socket).

5. Resurfacing: Using specialized instruments, the damaged surface of the femoral head is trimmed and shaped to accommodate the metal cap or covering. A metal shell is also placed into the acetabulum.

6. Implant placement: The metal cap is then securely fitted onto the prepared femoral head, and the metal shell is positioned into the acetabulum. These components may be secured with or without bone cement.

7. Closure: After confirming proper placement and stability of the implants, the surgeon closes the incision using sutures or staples.

8. Recovery: The patient is monitored in the recovery room before being transferred to a hospital room or discharged home. Physical therapy and rehabilitation are initiated to promote healing, restore mobility, and strengthen the hip muscles.

9. Follow-up: Regular follow-up appointments are scheduled to monitor the patient's progress, address any concerns, and ensure the success of the hip resurfacing procedure.

Risks associated with hip resurfacing

• Infection

• Blood clots

• Fracture

• Dislocation

• Metal ion release

• Nerve damage

• Leg length discrepancy

• Implant failure

• Limited range of motion