Hip Resurfacing

What Is Hip Resurfacing?

Patients with serious hip conditions can benefit from hip resurfacing. In order to preserve your femur (thigh bone), our orthopedic surgeon uses the Birmingham Hip Resurfacing System (BHR).

Resurfacing the hips is an advanced procedure that helps patients recover more quickly. In addition to improved stability and longer longevity, the BHR implant may allow you to participate in more physically active pursuits. Why Might I Need Hip Resurfacing?

You might consider hip resurfacing if you’re an active adult under the age of 60, or over 60 but physically active. Some serious hip problems include:

• Developmental dysplasia of the hip (DDH)
• Avascular necrosis (AVN), or hip osteonecrosis
• Osteoarthritis
• Bone spurs on the hip
• Rheumatoid arthritis

As a first step, we often recommend conservative treatment for hip pain, such as:

• Cox-2 inhibitors
• Corticosteroids
• Glucosamine and chondroitin dietary supplements
• Exercise
• Physical therapy
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Using a cane
• Weight loss programs
• Avoiding spending a long time walking or standing

Hip resurfacing is a less invasive alternative to total hip replacement if these treatment options do not work.

How Is Hip Resurfacing Carried Out?

In either case, you are asleep while the procedure takes place or you are numbed below the waist with an epidural.

The doctor can preserve your femoral head and neck by using the BHR implant. Your femur is filled with a ground ball that sits in the pelvic socket. A small amount of bone must be removed to fit the femoral head snugly into the BHR implant.

Our orthopedic surgeon then prepares the acetabulum, which is the socket where the head of the femur sits in the pelvis. As the second component of the BHR implant, the resurfaced femur head sits inside the acetabulum.

The soft tissues can now be repaired by our orthopedic surgeon, and the operation is complete. Your rehabilitation program is arranged by our orthopedic surgeon. If you want to maximize your recovery, you should follow the program.

There is no need to undergo a total hip replacement just because you have painful hips.

Advantages of Hip Resurfacing

It is highly controversial among orthopedic surgeons whether hip resurfacing is better than traditional total hip replacement. Currently, there is research being done on this topic.

You may be able to revise hip resurfacing more easily. A hip replacement or hip resurfacing is a mechanical surgery, so the components (called implants) can – and do – wear out or loosen over time. Implants are most commonly replaced within 15 to 20 years from their placement. However, they can last longer or shorter.

A second surgery may be required if the implant fails. An additional procedure known as a revision is frequently more challenging than the original operation. In addition to removing less bone from the femur (thighbone) when compared to a traditional hip replacement, hip resurfacing also makes it easier for surgeons to replace a failing implant.

Dislocation of the hip is decreased. As in a traditional hip replacement, hip resurfacing has a larger ball, similar to the size of your natural hip ball. Dislocation may be more difficult because of this. Some experts believe this stance is controversial since several factors affect the risk of dislocation, including surgical methods, implant diameter, and size.

The walking pattern is more like normal. According to some studies, hip resurfacing allows for more natural walking patterns than traditional hip replacement. It is difficult to measure these subtle differences, however, since they affect how people walk.

Disadvantages of Hip Resurfacing

Fracture of the neck of the femur. In a minority of patients who undergo hip resurfacing procedures, the thighbone will eventually break (fracture). A hip resurfacing procedure will often have to be converted to a regular hip replacement if this occurs.

A femoral neck fracture is unlikely during a traditional hip replacement procedure because the femoral neck is removed during the procedure. Fractures around implants can also occur with traditional hip replacements.

Metallic ions pose a risk. Metal balls are moved inside metal sockets during hip reconstruction. A molecule of metal called an ion is released overtime when the two surfaces rub against each other. The ions can cause a reaction in the bone and soft tissues surrounding the joint called an adverse local tissue reaction. Revision surgery may be needed if this occurs. It can lead to swelling and pain. In addition to entering the bloodstream, the ions can have systemic effects as well. As a result, hip resurfacing is no longer as common as it once was.

These traditional hip replacements also have metal balls and metal sockets and carry the same risks as metal ball replacements.

Surgical Procedure

A hip resurfacing generally takes between 1-1/2 and 3 hours.

An incision in your thigh will be made so that your doctor can access your hip joint. The femoral head will then be dislocated out of its socket. In the next step, special power instruments are used to trim the head. The prepared femoral head is covered with a metal cap. Using a power tool called a reamer, the cartilage lining the socket is removed. There is then a metal cup inserted into the socket and held in place by friction between the metal and the bone. In order to reposition the femoral head back into the socket, the incision has to be closed after the cup has been placed.

After your surgery, you will be taken to the recovery room, where nurses will keep an eye on you until you are recovering from anesthesia. Your hospital room will then be shown to you.