When looking at hip surgery, there are two main choices: hip resurfacing and total hip replacement. With hip resurfacing offering a bone preserving alternative, the best option is entirely dependent on your condition, your age, your level of activity and your goals from treatment.
A hip replacement involves replacing the entire joint including the ball, the socket and the femoral neck. Hip resurfacing surgery solely replaces the hip socket.
But which should you opt for? Let’s delve into each treatment so you can make an informed decision when discussing with your orthopaedic surgeon.
What are Hip Replacement and Hip Resurfacing? A Detailed Comparison
Hip Replacement
In a total hip replacement, the entire hip joint is recreated using prosthetics made from ceramic, metal and silicone. The ball, socket and femoral head are removed and replaced during treatment, offering a solution that can last for up to 20 years in some cases. As a result of this lifespan, it’s a treatment that is commonly used for older patients. Understanding the total hip replacement protocol can be helpful for some patients.
Hip Resurfacing
Hip resurfacing is a treatment that aims to preserve bone. Instead of the entire femoral head being removed and replaced, it is simply shaved down and a metal cap placed atop. It is a more complex surgery than a total hip replacement but comes with many benefits, especially for younger patients as more of the femur is preserved.
Preserving Bone: The Key Advantage of Hip Resurfacing
The main benefit of hip resurfacing treatment is bone preservation. This is important because it means that there is more bone to work with if future treatment is needed. If you are younger then it’s expected that you will need more treatments in the future; perhaps 20+ years down the line, and bone preservation gives you more options.
Bone preservation also aids your return to activity following surgery by ensuring a more normal gait and better stability. So, if you have a higher activity level, it’s a great choice of treatment compared to a full hip replacement.
Advantages and Disadvantages of Hip Resurfacing
Advantages
- Bone Preservation: Hip resurfacing surgery removes less of the femur enabling future surgeries if needed. This is a great advantage if you are younger than 60 years of age and enjoy an active lifestyle.
- Normal Gait: When compared to traditional hip replacement surgery, resurfacing is known to offer a more natural walking pattern post-surgery. This is because there is less chance of leg length discrepancy and no risk of foot direction defects.
- Resilience: For those who enjoy a high level of physical activity, hip resurfacing has the advantage. It is more resilient in high impact sports such as skiing and running, giving better performance. And as the size of the metal cap remains close to the size of your femur head in size, the risk of dislocation during activity is lower than with a full hip replacement.
Disadvantages
- Complexity:When compared to a full hip replacement, hip resurfacing surgery is much more complex to perform. This leads to a longer surgery and could increase the risk of complications.
- Larger incision:As a result of the complexity of hip resurfacing treatment, a larger incision is required. This could have an impact on recovery time.
- Precision:With hip resurfacing surgery, the need for precision when positioning the main components is much greater than in traditional hip replacements.
Understanding the Risks: Dislocation and Metal Ions
Both hip resurfacing and hip replacement surgeries are usually safe and effective. But no treatment comes without risk. These include:
- Dislocations:As a result of the joint becoming weakened during surgery, there is a risk of dislocation. This risk is increased in the first months of recovery as your muscles and ligaments return to full strength.
- Metal Ions:It’s possible for these ions to build up around the hip joint and they could then spread to the blood. To minimise this risk, your bloods will be monitored closely following surgery.
Other risks include:
- Infections and blood clots.
- Femoral neck fractures.
- Nerve damage.
These risks are rare and if you have any concerns about the potential risks or treatment, get in touch with your healthcare provider.
Choosing the Right Path: Who is a Candidate for Each Procedure?
Hip Replacement Candidate
A good candidate for hip replacement surgery is someone who:
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- Is over the age of 60.
- Has evidence of significant joint deterioration.
- Has weaker bones that cannot be retained.
Often, a total hip replacement comes after failed conservative treatment efforts. If someone has reduced mobility and increasing levels of pain despite attempting non-surgical treatment methods such as medications and physical therapy, they are typically a good candidate for hip replacement surgery.
Hip Resurfacing Candidate
Due to the nature of hip resurfacing treatment, the best candidate is someone who:
- Is under the age of 60.
- Has an active and healthy lifestyle.
- Has a good level of bone health.
The size of the hip bones will also be a significant factor on whether someone is a good candidate for hip resurfacing treatment.
As a general rule of thumb, the larger the hip bones, the better the candidate. And as men typically have larger bones than women, they usually make the best candidates. But it’s important to note that each case is unique.
Recovery and Longevity: What to Expect from Your Surgery
Your recovery journey will depend on the type of hip surgery that you have had but you can expect three stages. A realistic hip replacement recovery timeline will vary from person to person, but understanding the main stages can make the process less daunting.
- Immediately After Surgery: You can expect a short stint in hospital following your surgery where you will be monitored regularly and begin physiotherapy.
- The First Few Months:There will be at least a few months of physical rehabilitation once returning home. You should listen to your healthcare provider’s advice during this time for optimal recovery. This is also the stage where hip precautions post surgery are most important, particularly in the early weeks after treatment.
- Long Term Recovery: It could take up to a year for you to fully recover from surgery and you will continue physical therapy throughout this time.
Speak to an Expert
For more information on hip resurfacing and hip replacement surgeries, reach out to Dr. David Slattery on 03 5752 5020. Read more about Dr. Slattery and his qualifications here.
