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Some patients with arthritis of the hip will have to undergo surgery. One of these types of surgeries is known as hip resurfacing surgery. This article outline the 5 things you should know about hip resurfacing surgery.

Arthritis is a common condition that currently has no cure. Fortunately, there are several treatment methods that can help reduce joint pain and inflammation, which are the characteristic features of arthritis. Generally, these treatments include mediation and physical therapy. However, in extreme cases, patients with advanced arthritis of the hip can undergo surgery.

These patients can either have a traditional total hip replacement (arthroplasty) or hip resurfacing (hip resurfacing arthroplasty). While both these surgeries involve replacing your hip joint, there are significant differences between the two.

A hip resurfacing surgery lasts around one and a half to three hours. It begins with your surgeon making an incision in your thigh to reach the joint that is affected by arthritis. Then, the head of the thighbone is dislocated from the socket and the head is trimmed using special instruments. Next, a metal cap is cemented on top of the head of thighbone. Then, the cartilage of the socket is removed using a reamer (a type of power tool). A metal cup is then put into a socket and held by friction. Once the femoral head is put back into the socket, the incision is closed. After the surgery, you will be monitored in the recovery room and then taken to a hospital room.

These are the five things you should know about hip resurfacing surgery.

1. Hip resurfacing is different from total hip replacement

In a total hip replacement, the surgeon removes the head of the thighbone and the damaged socket and replaces them with components that are made up of metal or plastic. However, during hip resurfacing, the head of the thighbone is not removed. In fact, it is trimmed and capped over with a smooth metal covering. However, similar to a traditional total hip replacement, the damaged bone and cartilage within the socket are removed and replaced with a metal component.

2. There are several advantages to undergoing a hip resurfacing compared to a traditional total hip replacement

One of the advantages of hip resurfacing is that this surgery is actually easier to revise than a total hip replacement. As implants that are used in hip replacements and hip resurfacings are mechanical, they tend to wear out over time, which occurs over a period of approximately 20 years. Thus, surgeons often have to go back and conduct a revision surgery, which is generally more complicated that the original operation. Since the hip resurfacing surgery involves removal of less bone from the thighbone, surgeons find it easier to revise a hip resurfacing compared to a total hip replacement.

Another advantage is that patients who undergo hip resurfacing have a reduced risk of hip dislocation. In the case of hip resurfacing, the size of the ball is closer to the size of the natural ball of your hip, and therefore harder to dislocate. (Several other factors also impact your risk of hip dislocation, however.)

Finally, doctors also find that patients have a more normal walking pattern after a hip resurfacing surgery compared to a traditional hip replacement. These differences are subtle and not noticeable to the naked eye.

3. There are also disadvantages to hip resurfacing

One of the disadvantages of hip resurfacing is that a small number of patients eventually experiences a break in the thighbone at a region called the femoral neck. In this case, surgeons will have to turn the hip resurfacing into a traditional hip replacement mid-surgery. This does not occur in patients undergoing a traditional hip replacement as the femoral neck is actually removed the surgery.

Another disadvantage of hip resurfacing is metal ion risk. In people who undergo a hip resurfacing surgery, an implanted metal ball moves within a metal socket. Hence, over time, the friction between the two different surfaces actually causes a release of tiny metal molecules known as ions which cause adverse reactions in the region in which they are released. This causes pain and swelling and the patient may need a revision surgery.

4. There are complications associated with this procedure

Similar to other surgical procedures, this one carries risks. While rare, some of these risks include infection, blood clots, injury to nerves or other blood vessels, femoral neck fracture, dislocation of the joint and anesthesia risks. The doctor will try to reduce these risks. For example, in order to prevent infection, the doctor will give you antibiotics from the start of the surgery to 24 hours after. For blood blots, doctors will likely give you blood thinners or other drugs.

5. You will likely recover within a few weeks of your surgery

Most patients tend to go home within one to four days after their surgery. You can actually start to put weight on your leg immediately after your surgery as long as your doctor allows you to. However, you may need a walker, cane or other tools to help you get around the first few days or weeks. There will be some pain and discomfort after the surgery, but will go away after several weeks. If you need to, you can use pain medication. Talk to your doctor if you have any questions. 

  • Treacy, R. B. C., C. W. McBryde, and P. B. Pynsent. "Birmingham hip resurfacing arthroplasty: a minimum follow-up of five years." The Journal of bone and joint surgery. British volume 87.2 (2005): 167-170.
  • Shimmin, A. J., and D. Back. "Femoral neck fractures following Birmingham hip resurfacing: a national review of 50 cases." The Journal of bone and joint surgery. British volume 87.4 (2005): 463-464.
  • Langton, D. J., et al. "Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: a consequence of excess wear." The Journal of bone and joint surgery. British volume 92.1 (2010): 38-46.
  • Photo courtesy of SteadyHealth

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